Saolta University Health Care Group win Best Sustainable Healthcare Project at the 2016 Irish Medical Times Healthcare Awards

The Atlantic Diabetes in Pregnancy (DIP) Research Group at Saolta University Health Care Group won two awards at the Irish Medical Times Healthcare Awards 2016 which was held in Shelbourne Hotel on 10 November. 

University Hospital Galway, Mayo University Hospital and Letterkenny University Hospital on behalf of the Saolta University Healthcare Group scooped the award for Best Sustainable Healthcare project and the over-all award‘ An Dhuas Mhór’ for their Pregnancy Care Programme for Women with Diabetes.

Professor Fidelma Dunne, Consultant Endocrinologist, University Hospital Galway explains how the programme came about, “Before 2006, there were no pre-pregnancy care clinics available in the West of Ireland and Pre-pregnancy care is very important in improving poor pregnancy outcomes for women with diabetes.

“The objectives of the programme were to:

•          Increase awareness of the risks associated with diabetes in pregnancy among healthcare providers in the West of Ireland – those   included: elevated rates of stillbirth, congenital malformations, admissions to neonatal intensive care units and preeclampsia.
•          Highlight the importance of pre-pregnancy care among women with diabetes and healthcare providers in the West of Ireland.
•          Provide gold standard care for women with diabetes (including type 1 and type 2 diabetes) in the West of Ireland.
•          Ensure that this care would be easily and freely accessible for all eligible patients.
•          Improve clinical outcomes for women with diabetes in pregnancy.
•          Evaluate the program from a cost viewpoint.

“In 2006 the Atlantic Diabetes in Pregnancy (DIP) research group was successful in an application for a research grant from the Health Research Board of Ireland (HRB).  This provided initial funding to develop and initiate the program and facilitated analysis of the program and publication of results.  The pre-pregnancy care program was devised according to principles laid out in National Institute for Health and Care Excellence (NICE) guidelines.  General practitioners and endocrinologists across the region were informed of the new pre-pregnancy care service.  Women of childbearing age with diabetes on the regional diabetes register were also informed in writing about the new service.  Free information seminars for women with diabetes took place across the region. 

“The pre-pregnancy care program was then initiated at three hospital sites and over 250 women have benefited to date.  The program is considered part of a sustainable, routine service provided by the Saolta Healthcare Group.”

The Atlantic Diabetes in Pregnancy Care service reviews women who are planning pregnancy on a monthly basis and covers the following areas:

•          Patient education (including diabetes nurse specialist and dietician reviews).
•          Medication review – stopping any medications that could be harmful in pregnancy.
•          Assessment and treatment of diabetes and thyroid complications.
•          Commencement of high dose folic acid to reduce incidence of congenital abnormalities.
•          Intensive glucose control – aiming for a HbA1c of <6.5%.

A consultant endocrinologist based at the central hub in University Hospital Galway travels regularly to the other locations to support the local clinicians and a local endocrinologist, diabetes nurse specialist and dietician assist with the delivery of the program locally, and a centrally located coordinator monitors data collection for each site.

Referrals to the program are accepted from specialist providers, primary care clinicians and women who self-referred. Women and healthcare practitioners are provided with a program information leaflet on an annual basis to encourage attendance.

The outcome of the programme to date:

•          Women with diabetes in pregnancy living in the West of Ireland have access to a bespoke and sustainable pre-pregnancy care program.
•          Free, gold standard care to optimise their health before embarking on pregnancy and improving pregnancy outcomes.
•          There is no waiting list to attend the service.
•          A multidisciplinary team who are experts in this area and provide this care.
•          Excellent patient feedback.

The Atlantic Diabetes in Pregnancy Care Programme scientific paper has been published in the 2016 Journal of Clinical Endocrinology and Metabolism (JCEM).