Diabetes should be an inpatient priority | Viewpoint

Hospital leaders: I have some advice for you this American Diabetes Awareness Month. Make diabetes a priority.

Leah Binder, president and CEO of the Leapfrog Group (Image: Leapfrog Group)

I offer this advice with humility. We at Leapfrog learned its importance only two years ago, when we started working with Dr. Robert Gabbay, chief scientific and medical officer at the American Diabetes Association (ADA). Until then, we assumed diabetes was the purview of physician practices, primary care clinics, case management and myriad other settings of care outside of traditional inpatient care. What Gabbay and his team clarified for us: People living with diabetes are the purview of every corner of health care, including every hospital unit.

Considering the number of patients at stake and the disease’s unique challenges, hospitals need to be especially diligent. Nationally, as many as 1 out of every 3 inpatient beds are occupied by a person living with diabetes.

No matter what condition prompted their admission, diabetes complicates care and heightens the risk of bad outcomes. It also makes health equity a more distant goal. Racial and ethnic minorities living with diabetes have greater risk for complications. For instance, Black people with diabetes are twice as likely as white counterparts to require amputation.

All patients, diagnosed with diabetes or not, face serious risk of harm—or even death—from patient safety problems that plague American hospitals. According to the Office of the Inspector General, 25% of people admitted to a hospital suffer some form of harm from the stay, and half of those are preventable.

Diabetes compounds that serious risk. Mistakes in the timing and dosing of medication, overlooking subtle signs of clinical distress, slight changes in meals or simple miscommunication can quickly escalate the acuity of a patient’s condition when diabetes is part of their health profile.

Thankfully, there are many programs in place to advance patient safety in hospitals. But to our knowledge, none of them focus on patients with diabetes.

That is why we partnered with ADA to launch the first-ever inpatient diabetes recognition program, Recognized Leader in Caring for People Living with Diabetes. We will recognize hospitals for successfully attending to the particular needs—and dire risks—of their patients who are living with diabetes.

Many hospitals are unaware of the established and tested best practices for hospitals to safely care for inpatients living with type 1 and type 2 diabetes. Some are aware but unprepared to incorporate practices into their standard inpatient treatment protocols, citing budgetary or other reasons. With this recognition program, Leapfrog and ADA will bring market incentives and public attention to hospitals that do the right thing.

Hospitals that achieve the Leapfrog/ADA standards will be deemed a Recognized Leader in Caring for People Living with Diabetes. Leapfrog and ADA will highlight this recognition for our constituencies, including thousands of employers involved with Leapfrog and millions of Americans supporting ADA’s mission.

The new online application, which was informed by a national expert panel, includes questions about whether hospitals:

• foster diabetes self-management;
• deploy specialized care teams;
• assure strong patient education;
• prepare patients well for surgery, and;
• protect patients from needing emergency intervention.

Application materials and tools are now available online and may be submitted, at no cost, through January 15, 2024. The first list of Recognized Leaders will be announced in spring 2024. Applicants will not be scored or publicly reported if they don’t meet the guidelines for this recognition.

We hope one day all hospitals will become recognized leaders. Because when one third of your patients were admitted to your hospital, they didn’t leave their diabetes at the door. This recognition allows hospitals to distinguish themselves through actions that keep people living with diabetes safe and healthy.

Leah Binder is president & CEO of The Leapfrog Group, an independent, employer-driven nonprofit that publicly reports on patient safety and quality for U.S. hospitals and ambulatory surgical centers.