Patients with diabetes who are hospitalized often have changes in diabetes treatment regimen during hospitalization. In the ReCoDED study done at our institution, it was found that discharge instructions provided by Endocrine teams were not always accurately translated into discharge recommendations by primary teams. To address this issue, we implemented a “diabetes discharge recommendations note” (EFR Note) which clearly specifies discharge instructions for primary teams, which we embedded in the institution’s EMR in January 2019. Preliminary data evaluating the efficacy of the EFR Note at our academic center showed significantly improved accuracy in the discharge regimen.

In this study, we investigated the patient data from two other centers, specifically inner-city community hospitals, from January to December 2021. We identified 40 patients through EMR for whom an EFR Note was utilized (EFR Group) and randomly selected 40 patients from the same centers for comparison (Control Group) . There were no significant differences in baseline characteristics between the two groups (All p values > 0.25)

Results: We find that the accuracy of diabetes regimens provided by primary teams at discharge was significantly higher when EFR Note was utilized, relative to control (88% vs. 60%; χ2 (1) = 6.46, p = 0.011) . The most common error was incorrect insulin type/dosing, accounting for 76% of all errors. Insulin dosing errors were similarly less prevalent in the EFR Group relative to control (8% vs. 33%; χ2 (1) = 6.33, p = 0.012) .

Conclusion: These results demonstrate that tools like EFR Note with specific instructions regarding discharge regimen can ameliorate deficiencies in discharge process. We plan to take steps to enhance awareness regarding the efficacy of EFR Note among endocrinology providers at multiple centers within our institution to facilitate a safer transition from inpatient to outpatient setting.


J.Lloyd: None. T.Abdulwahid: None. J.Levin: None. D.Pinkhasova: None.

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