Notification of random hyperglycaemia to general practitioners by an emergency medicine team: impact of a simple intervention plan

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Abstract

Aim

To determine whether general practitioners (GPs) were being appropriately notified of patients' elevated random glucose levels by emergency medicine (EM) staff, and to investigate whether two simple interventions improved the notification rate.

Methods

Patients were included if their random venous plasma glucose (RVPG) at presentation to the Emergency Department (ED) was ≥ 7.8 mmol/l and if they were discharged directly to their GP. Patients with known impaired glucose metabolism (IGM) were excluded. Patient discharge summaries were reviewed over a 5-month period before and a 5-week period after two simple interventions: first, a targeted educational session for EM staff and second, modifications to the automated message accompanying laboratory results.

Results

Before intervention, the GPs of 120 out of 178 patients received no notification of an elevated RVPG compared with 23 of 62 patients after intervention (P < 0.00001). Notification met a predefined standard in 25 of 178 patients before, and 34 of 62 patients after intervention (P < 0.01).

Conclusions

EM staff education, together with an automated laboratory message, significantly improved the rate and quality of notification of elevated RVPG levels to GPs. These simple measures have the potential to hasten implementation of preventive and therapeutic measures in patients with IGM.

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