Many nurses combine discharge planning and patient education. One model that formalised this function for people with diabetes demonstrated decreased lengths of stay, costs, and readmissions. A study was undertaken in Columbus Regional Medical Center in Columbus, GA (413 bed tertiary centre). The admission rate for this centre in 1998 was 16,799 (2% diabetes primary, 9.8% diabetes secondary). ALOS 7.5 days in 1996, reduced to 4.2 days in 2001, readmission rate 82 in 1996, reduced to 22 in 2001. Due to formalising the combination of discharge planning with patient education, a reduction in LOS, associated costs and readmissions were seen. All inpatients with diabetes received the intervention. Diabetes education and patient support moved to a discharge-planning department. The number of personnel expanded from 1/3 FTE diabetes nurse specialist to 2 fulltime diabetes nurse specialists and a part-time secretary. The service provided incorporated a mixture of patient education and discharge planning functions. The diabetes nurse specialists worked within a Discharge Planning Department allowing for provision of interfaces with community services. Financial advantages, through reduced lengths of stay and a reduction in recidivistic admissions, were yielded despite the initial investment in service required (Leichter et al 2003).
