VOICeD – Diabetes in Pregnancy

Overview

Initiative type

Model of Care, Service Improvement

Status

Deliver

Published

16 February 2023

Summary

This program enables women at Logan Hospital to access specialist diabetes care from their community midwifery hub using VOICeD. For the patients this service is convenient and connected to their care providers, and the service reduces hospital visits.

The diabetes midwifery team, endocrinologists, dietitians, administration officers and community cultural support workers, among others, have all worked together with women with diabetes in pregnancy to develop a service with them and for them.

Watch VOICeD for diabetes in pregnancy from Clinical Excellence Division on Vimeo.

Key dates

Feb 2022 - Jun 2023

Implementation sites

Logan Hospital, Metro South Health

Partnerships

Maternity Care Hubs Logan, Village Connect, CEQ Health Improvement Unit, QUT Design Lab, consumers

Aim

Using the existing framework for VOICeD, the aim of the VOICeD Diabetes in Pregnancy project is to better integrate existing care delivery for women who access maternity care in Logan for their diabetes in pregnancy, using telehealth appointments with multiple providers.

Outcomes

  • integrate endocrinology, dietetics, midwifery and cultural support for women with diabetes in pregnancy, resulting in fewer appointments
  • less travel and more convenient appointments

Background

VOICeD (Virtual Outpatient Integration for Care Delivery) is an expanding program that streamlines and improves the experience of consumers who regularly engage with multiple outpatient care providers.

VOICeD allows a person with complex care delivery requirements to see multiple healthcare providers at one appointment, via telehealth. This reduces travel time, and cost of healthcare for the individual and for the Hospital and Health Service

The person sees each specialist or care provider individually and a multidisciplinary team meeting can be held to further support individualised and comprehensive care. Patients suitable for telehealth are suitable for VOICeD.

The model started in Cairns in 2020.

Methods

VOICeD Diabetes in Pregnancy clinics at Logan Hospital include women with insulin treated diabetes in pregnancy from the Pasifika Maternity Hub in Logan in collaboration with Village Connect. The women are seen by an endocrinologist, dietitian and supported by their midwives and/or community cultural support workers.

The first 2,000 days of life, commencing pre-conceptually with the development of the sperm and the ovum, are critical to long-term health and wellbeing. Sub-optimal health outcomes at the start to life can manifest in chronic disease with long term costs for individuals, families, and health systems. Maternity and midwifery group practice care provided at the Community Maternity Hubs model within Logan Hospital is safe, improves antenatal attendance and engagement as well as a range of maternity and neonatal outcomes including social determinants of health for priority populations. One of the goals for VOICeD Diabetes in Pregnancy Logan is that the women reduce the frequency of their appointments and trips into the hospital. VOICeD also enables them to have their dietitian and endocrinology appointments in a single appointment with either their midwife or community support worker.

Discussion

Data shows that the Logan local geographical area has twice the number of people with gestational diabetes (4.4%) than the rest of the nation (2.2%) [1].

Feedback on patient experience surveys have been positive, with the majority of respondents stating their overall experience is “Very Good” and liked the “Less travel”, “Less time waiting” and that “Pregnancy and diabetes teams spoke to each other”.

Lessons learnt

Starting small has its value but sometimes there is more to be gained by getting larger numbers through the service in order to streamline processes.

References

  1. National Diabetes Services Scheme . Diabetes Map (ndss.com.au)

Further Reading

Virtual Outpatient Integration for Chronic Disease (VOICeD) | Improvement Exchange | Clinical Excellence Queensland | Queensland Health

Key contact

Jenna Newton

Nurse Practitioner, Logan Hospital

Metro South Hospital and Health Service

Email:  Jenna.newton@health.qld.gov.au

Last updated: February 2023

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