The HSE Model of Integrated Type 2 Diabetes Care recommends that people with uncomplicated type 2 diabetes (T2D) should receive their care in general practice. Some Irish diabetes outpatient clinics have begun to transition people with uncomplicated T2D back to general practice. However, there is no structured approach or guidance for Irish healthcare professionals on how best to manage this transition.
Aims
To develop a nationally agreed and evidence-based protocol for the safe management of people with uncomplicated T2D transitioning from outpatient services to primary care using a consensus methodology involving all key stakeholders.
Plan of investigation
Existing international transition protocols and current transition practices in Irish hospitals will be reviewed. Qualitative interviews with people with uncomplicated T2D recently transitioned to primary care, and health care professionals involved in diabetes care, will be conducted to explore issues around transition of care in the Irish setting. These data will be used to inform the consensus meeting with relevant stakeholder groups, and consensus will be reached on a nationally agreed transition protocol using a nominal group technique.
This protocol will be implemented in a representative sample of 15 general practices to determine its feasibility, acceptability and cost. Once the protocol has been finalised, the transition of care protocol will be disseminated nationally to all relevant stakeholder groups with the aim of national implementation.
Summary of the potential impact
If successful, the protocol can be implemented in hospitals nationwide. People with uncomplicated diabetes can receive their care closer to home while outpatient clinics can concentrate on managing those with complications. By ensuring this move is coordinated, problems such as poor communication and gaps in care can be avoided. Findings will be disseminated to key stakeholders with the aim of protocol implementation and national roll-out. The findings could also inform other chronic condition programmes.
