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P28 Improving transition for patients with diabetes: a service improvement project

Aims To examine what adolescents with Type 1 diabetes want from a transition service and to evaluate if the implementation of a Specialist Transition Nurse improves patient engagement and patient experience during transition. To implement a service development plan and consider how to evaluate the outcome. Methods This was a service improvement project performed during Feb-July 2018 in a district general hospital. 53 patients with Type 1 diabetes aged 14-19 years were invited to take part. Patients were surveyed about their experiences and views on transition via two patient questionnaires (pre-intervention and 6 months post-implementation of the transition nurse). Qualitative data was also collected via semi-structured interviews. Results The response rate for the pre and post-intervention questionnaires was 72% and 66% respectively. Overall, 73% of subjects reported one or more anxieties regarding transition to adult diabetes care. The top two reported anxieties were having to be more independent and the possibility of being admitted to an adult ward. The most common reasons for not attending clinic were that appointments ‘clashed’ with school or were booked too far in advance. The majority of respondents did not want to meet with the diabetes team at school or have ‘virtual’ appointments. Overall, the young people felt satisfied with the support provided by the transition nurse. Three key themes were identified from the structured interviews, flexibility of services, the need for more support and worry regarding taking on increased responsibility. Conclusion A specialist transition nurse may lead to improved patient engagement and patient experience during transition. Patients want more flexibility around appointment times and more support throughout transition. Further research is required to look at specific outcome measures such as glycosylated haemoglobin (HbA1c) and hospital admission rates to determine whether the presence of a transition nurse translates into improved outcome measures in the longer term.