Quality Standards for Diabetes Care Toolkit

Introduction to the toolkit

Diabetes mellitus is a long term complex metabolic disorder characterised by high levels of blood glucose and caused by defects in insulin secretion and/or action. Diabetes increases the risk of damage to the heart, brain, eyes, kidneys, nerves, blood vessels and many other body systems. It is expected that implementation of improved care processes as described in this set of twenty Quality Standards for Diabetes Care in NZ (the Standards) will reduce the complications, morbidity and mortality associated with diabetes. The Standards are arranged into five topic groupings:

Basic care, self-management and education

Management of diabetes and cardiovascular risk

Management of diabetes complications

While in hospital

Special groups.

These standards for Diabetes Care need to be considered as part of an overall systems approach to diabetes. They should be considered in their entirety and implemented via an alliancing framework. Service level alliances should include people with diabetes and utilise clinical governance processes to reduce variation, share learning and focus on improving safety, quality and cost effectiveness.
Health care is a complex, adaptive system and, as such, ongoing adjustment will be necessary. Due to the multifaceted nature of diabetes, its management draws on many areas of health care, and care is ‘typically complex and time-consuming’ (NICE 2009, p 4). According to NHS Diabetes (2010) ‘People with diabetes should receive regular structured care, annual or more frequently as appropriate, based on a care planning approach’ (p 4).
The Standards describe principles for high-quality, cost-effective care that, when delivered collectively, should improve the effectiveness, safety and experience of care for people with diabetes in the following ways (NICE 2009):

enhancing both physical and psychological quality of life

treating and caring for people in a safe environment and protecting them from avoidable harm

ensuring that people have a positive experience of care

helping people to recover from episodes of ill health

preventing people from dying prematurely or experiencing disability.