Development of a transdisciplinary diabetes model of care in a rural service

Ms Petrea Cronwell3, Ms Cristal Newman1, Ms Sonia Small3, Ms Elizabeth Ward2

1Community and Allied Health, Roma Hospital, Roma, Australia, 2Centre for Functioning and Health Research, Metro South HHS; and The University of Queensland, St Lucia, Australia, 3School of Allied Health Sciences, Griffith University, Gold Coast, Australia

Abstract:

Context And Aims
Provision of healthcare for clients with diabetes can be challenging, particularly in rural health services with limited resources. In South West Hospital and Health Service, an Accredited Practising Dietitian (APD) and a nurse Credentialed Diabetes Educator (CDE) traditionally provided care within a multidisciplinary service model. Existing service inefficiencies prompted exploration of a new transdisciplinary service model, aiming to improve service efficiency and patient care.
Method
Diabetes assessment and intervention tasks completed within the scope of practice of a registered nurse, APD and/or CDE were identified and documented. The patient journey was mapped and parameters for inclusion in a shared initial assessment tool were identified. Referral criteria for patients requiring specialised assessment and intervention by either the nurse CDE, APD, Nurse Practitioner or Medical officer were developed. Acceptability of the model was tested with referral sources.

Results:
The results of mapping activities were used to develop a transdisciplinary diabetes service model. Opportunities for skill sharing, implementation of extended scope practices (including provision of advice on insulin dose adjustment and pathology requesting) and reducing service duplication were identified. A transdisciplinary diabetes model of care was produced including a comprehensive transdisciplinary initial assessment tool, defined referral criteria and skill share clinical task instructions for new tasks. The model demonstrated high levels of acceptability with key stakeholder groups.
CONCLUSION:
Development of transdisciplinary healthcare models provide an opportunity to identify areas for skill sharing, reduced service duplication and improved patient care.


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