BACKGROUND:
Demand on resources providing Continuous Subcutaneous Insulin Infusion (CSII) services is growing at a significant rate. NDSS figures and communication with paediatric colleagues indicate that up to 40% of children with Type 1 diabetes are managed with CSII. There is increasing concern amongst Health Professionals in adult metropolitan hospitals that current service models will not manage the large numbers of paediatric patients transitioning to the adult health services, in addition to adult patient demands.

AIM:
To identify opportunities for quality improvement in our CSII program.

OBJECTIVE:
To benchmark our CSII service against other major metropolitan health services.

METHOD:
A nineteen point questionnaire was developed after review of existing CSII best practice and discussions with Endocrinologists and Credentialed Diabetes Educators (CDE) with CSII expertise.
Using this questionnaire, two Diabetes Educators from our health service visited six metropolitan hospitals to gain insight into how their pump services were resourced and structured.

RESULTS:

A number of areas in our pump service did not follow current best practice.

Priority gaps were identified as:

1. A lack of formal structure was hindering throughput of pump initiation/upgrades
2. Patients lacked access to a Pump information session
3. There was no dedicated CDE EFT to manage our CSII service

OUTCOMES:
1. Benchmarked our CSII service.
2. Comprehensive staff and patient resources were developed using current best practice.
3. A business case is being prepared to increase EFT.

CONCLUSION:
Benchmarking our CSII service was a valuable quality activity which allowed us to identify areas not meeting current best practice. As a consequence, we have implemented prioritised changes to maximise our ability to meet the continually increasing demand for CSII therapy.