Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consultations

• Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length of stay among patients in a single center by 1,342 days and saved the hospital $1.15 million.

• The active involvement of the endocrinologist with the surgical team helped decrease the patients’ length of stay and reduced hospital expenses
• Overall, it pays economically for the hospital, and very well for patients in terms of improved quality of care.
• It is unclear whether these consults provide a net benefit outside of the intensive care unit (ICU).
• The researchers had previously assessed whether aggressive management of diabetes in cardiac and transplant surgical patients shortened length of stay –- which it did –- and the idea of the current study was to see whether that would extend to general surgery patients as well.
• An endocrinologist or diabetes educator provided advice on blood sugar management as soon as abnormal blood sugars were detected, rather than waiting for the surgical team to ask for assistance.
• Patient glucose levels were consistently monitored, and the intervention was initiated when those levels fell below 50 mg/dL or rose above 200 mg/dL.
• The researchers found that mean length of stay and cost were significantly lower in 2009 after the intervention started.
• In 2009, there was also a trend toward more patients being released home, rather than to other institutions, but it was not significant. A trend toward improved mortality wasn’t significant, either.
• For all patients taken together, the total savings in length of stay and costs was 1,342 days and $1.15 million -– with 656 days and $1.06 million of that improvement attributable to the better outcomes for diabetic patients.

http://www.kevinmd.com/blog/2010/05/endocrinologists-improve-surgical-care-diabetic-patients.html