1171-P: Endocrine Final Recommendation Note (EFR) Embedded in the Electronic Medical Record (EMR) Improves the Discharge Process for Hospitalized Patients with Diabetes (DM)

Abstract

Hospitalized patients with DM represent a group at high risk for readmission. Variability in how instructions for home DM management are provided at discharge can contribute to this risk. At our institution, recommendations made by the endocrine consult service were not always accurately translated into patient discharge orders by the primary service. Therefore, the EFR embedded within the EMR was developed. We investigated its effectiveness by reviewing the EMR of 48 patients discharged with insulin prior to (group 1) and following implementation (group 2) for fidelity of recommendations carried out by the primary service. Accuracy of the diabetes-related discharge regimen was defined as correct type and dose of insulin, correct administration supplies (syringes vs. pen needles), and provision of appropriate glucose monitoring supplies by the primary team. About 50% of patients had a change in their DM regimen at discharge. Insulin was added as a new medication in 29% vs. 44% of patients in groups 1 and 2 respectively. There was significant improvement in the accuracy of the diabetes-related discharge regimen (68% vs. 96%, p = 0.001). These results demonstrate that deficiencies in the discharge process can be ameliorated by EMR tools which facilitate a safer transition of care from inpatient to outpatient settings for patients with DM. Disclosure D. Pinkhasova: None. A. Donihi: None. K. Feterik: None. M.T. Korytkowski: None. E. Karslioglu French: None.