The rapidly changing NHS environment creates pressure on clinical services to deliver better care and overhaul reporting requirements while at the same provide tangible evidence that efficiency gains are being made. RioMed’s Diabetes System, Cellma enables clinicians, service managers and administration staff to meet all the requirements laid out in The Outcomes Framework and the new diabetes NICE Quality Standard.

The Diabetes Quality Standard conatins 13 quality statements which have associated measurements for NHS organisations to collect data on. RioMed’s Diabetes system Cellma generates reports on quality standard measurements at the click of a button

The Diabetes Quality Standard measurements include elements the following documents:

• NICE clinical guideline 10 (CG10)

• NICE clinical guideline 15 (CG15)

• NICE clinical guideline 63 (CG63)

• NICE clinical guideline 87 (CG87)

• NICE clinical guideline 119 (CG119)

• The National Diabetes Audit

• Hospital Episode Statistics

• National Screening Programme for Diabetic Retinopathy

• Care Planning in Diabetes (2006)

• Quality & Outcome Framework Indicators

Outlined below are details of the ways in which Cellma can help your service meet each quality standard measurement:

Quality Statement 1- Structured Education:

People with diabetes and/or their carers receive a structured educational programme that fulfils the nationally agreed criteria from the time of diagnosis, with annual review and access to ongoing education.

Ways Cellma can help:

• Monitor the number diabetic adults who have been offered, have started or completed structured education
• Monitor those patients whose structured education has been reviewed and reinforced
• Electronic design and recording of educational programs in line with DOH and Diabetes UK Patient Education Working Group

Quality Statement 2- Nutrition & Physical Activity Advice:

People with diabetes receive personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme.

Ways Cellma can help: 

• Monitor the number of diabetic adults who receive advice on nutrition and/or physical activity.
• Monitor number of referrals onto relevant healthcare professionals (e.g: dietician/physical therapist) and/or diabetic specialist teams.

Quality Statement 3- Care Planning:

People with diabetes participate in annual care planning which leads to documented agreed goals and an action plan.

Ways Cellma can help:

• Monitor the number of diabetic adults who have been offered and/or have participated in an annual care plan
• Provide electronic customer satisfaction surveys for patients who participate in care planning
• Electronic design and recording of patient centred care plans in line with DOH’s adapted plans from Care Planning in Diabetes (2006)

Quality Statement 4- Glycaemic Control:

People with diabetes agree with their healthcare professional a documented personalised HbA1c target, usually between 48 mmol/mol and 58 mmol/mol (6.5% and 7.5%), and receive an ongoing review of treatment to minimise hypoglycaemia.

Ways Cellma can help: 

• Monitor number of diabetic adults with a measured HbA1c 
• Monitor number of diabetic adults who have an agreed target of HbA1c
• Monitor number of diabetic adults who are achieving their HbA1c target
• Alerts can alsoe be set up to notify clinicians automatically when patients are not achieving their
• Monitor number of diabetic adults who have received a review of their treatment

Quality Statement 5- Medication:

People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance.

Ways Cellma can help:

• Monitor number of diabetic adults who have received a medication review in the past 12 months
• Monitor proportion of diabetic adults whose blood glucose, blood pressure and blood lipids are managed in accordance with NICE guidance
• Monitor number of diabetic adults whose medications are not managed according to NICE guidance who have medical notes documenting clinical reasons for exception

Quality Statement 6- Insulin Therapy:

Trained healthcare professionals initiate and manage therapy with insulin within a structured programme that includes dose titration by the person with diabetes.

Ways Cellma can help:

• Monitor proportion of diabetic adults starting insulin therapy that is initiated by a trained healthcare professional
• Monitor number of diabetic adults who have appropriate training for starting and managing insulin
• Monitor proportion of diabetic adults who are receiving on-going support to initiate and manage insulin therapy

Quality Statement 7- Preconception Care:

Women of childbearing age with diabetes are regularly informed of the benefits of preconception glycaemic control and of any risks, including medication that may harm an unborn child. Women with diabetes planning a pregnancy are offered preconception care and those not planning a pregnancy are offered advice on contraception.

Ways Cellma can help:

• Monitor proportion of diabetic women of childbearing age who are regularly informed about the benefits of preconception glycaemic control and of any risks including medications that may harm an unborn child.
• Monitor number of diabetic women of childbearing age planning a pregnancy who are offered preconception care from an appropriately trained healthcare professional.
• Monitor number of diabetic women of childbearing age not planning a pregnancy who are offered advice on contraception.
• Cellma will be fully compatible with the presentational diabetes audit due to be rolled out in 2012

Quality Statement 8- Complications:

People with diabetes receive an annual assessment for the risk and presence of the complications of diabetes, and these are managed appropriately.

Ways Cellma can help:

• Monitor number of diabetic adults who are assessed annually for the risk and presence of complications of diabetes
• Monitor that their risks and complications are managed appropriately

Quality Statement 9- Psychological Problems:

People with diabetes are assessed for psychological problems, which are then managed appropriately

Ways Cellma can help:

• Monitor proportion of diabetic adults assessed for psychological problems.
• Monitor number of diabetic adults who have psychological problems that are being managed appropriately

Quality Statement 10- ‘At risk’ foot

People with diabetes with or at risk of foot ulceration receive regular review by a foot protection team in accordance with NICE guidance, and those with a foot problem requiring urgent medical attention are referred to and treated by a multidisciplinary foot care team within 24 hours.

Ways Cellma can help:

• Monitor number of diabetic adults with foot ulceration who receive regular review by a foot protection team in accordance with NICE guidance 
• Monitor proportion of diabetic adults at risk of foot ulceration who receive regular review by a foot protection team in accordance with NICE guidance
• Monitor number of diabetic adults with a foot problem requiring urgent medical attention referred to and treated by a multidisciplinary foot care team within 24 hours.
• Monitor proportion of diabetic adults with an urgent foot problem referred to a multidisciplinary foot care team who are treated in accordance with NICE guidance.

Quality Statement 11- Inpatient Care:

People with diabetes admitted to hospital are cared for by appropriately trained staff, provided with access to a specialist diabetes team, and given the choice of self-monitoring and managing their own insulin.

Ways Cellma can help:

• Monitor proportion of staff on inpatient wards who are appropriately trained to care for people with diabetes.
• Monitor proportion of diabetic adults who are provided with access to a specialist diabetes team.
• Monitor number of diabetic adults on insulin therapy who are given the choice of self-monitoring and managing their own insulin.

Quality Statement 12- Diabetic ketoacidosis

People admitted to hospital with diabetic ketoacidosis receive educational and psychological support prior to discharge and are followed up by a specialist diabetes team.

Ways Cellma can help: 

• Monitor proportion of people admitted to hospital with diabetic ketoacidosis who receive educational and psychological support by a specialist diabetes team prior to discharge.
• Monitor proportion of diabetic adults admitted to hospital with diabetic ketoacidosis who receive follow-up within 30 days after discharge by a specialist diabetes team.

Quality Statement 13- Hypoglycaemia

People with diabetes who have experienced hypoglycaemia requiring medical attention are referred to a specialist diabetes team.

Ways Cellma can help: 

• Monitor proportion of diabetic adults who have experienced hypoglycaemia requiring medical attention who are referred to a specialist diabetes team. 

In addition to all the benefits of adhering to the new Quality Standard for Diabetic Adults Cellma can also aid your service in creating electronic patient care pathways for all diabetes patient groups. For further information on Cellma’s best practice care pathways look out for our newsletter coming up at the end of April.

Cellma has also recently been chosen as the preferred supplier of diabetic software to the HSE across the whole of Ireland. The first roll-out of this project, which has been cited in Irish Medical Times, is due to go live at the end of April.

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