The effect of diabetes case management and Diabetes Resource Nurse program on readmissions of patients with diabetes mellitus

AIMS: Patients with diabetes have higher readmission rates than those without diabetes, yet limited data on efforts to reduce their readmissions are available. We describe a novel model of inpatient diabetes care, expanding the role of diabetes educators to include case management, and establishment of a Diabetes Resource Nurse program, aimed at increasing the knowledge of staff nurses, and evaluate the impact of this program on readmission rates. METHODS: We performed retrospective analysis of 30-day readmission rates of patients with diabetes before (July 2010–December 2011), and after (January 2012–June 2013) starting the implementation of this tiered inpatient diabetes care delivery model. RESULTS: We analyzed 34,472 discharged patient records from the 18-month pre-intervention period, and 32,046 records from the 18-month post-intervention period. The overall 30-day readmission rate for patients with diabetes decreased significantly from 20.1% (pre) to 17.6% (post) intervention (p < 0.0001). Patients seen by diabetes educators had the lowest 30-day readmission rates (∼15% during the whole study), a rate approaching the overall hospital readmission rates in those without diabetes in our institution. CONCLUSION: The Diabetes Resource Nurse program is effective in decreasing readmission rates. Patients seen by the diabetes educators have the lowest rates of readmission.