Diabetes Medication Review in Acute Illness Audit

This project audits the quality, completeness and reliability of diabetes medication review during acute illness. It reviews reconciliation, assessment of oral intake, fasting and renal function, insulin safety, glucose monitoring, hypoglycaemia and ketone risk, medicine-specific review of SGLT2 inhibitors, metformin, sulfonylureas and GLP-1/GIP agents, specialist and pharmacist escalation, documentation of medication changes and restart plans, and discharge communication including sick-day advice.

• Acute medicine, emergency medicine and general internal medicine teams
• Ward pharmacists and medicines optimisation teams
• Diabetes specialist nurses and inpatient diabetes teams
• Ward leadership, nursing teams, ACPs and physician associates
• QI leads, governance teams and educators

• Measure reconciliation and review of diabetes medicines during acute illness
• Assess whether oral intake, fasting status, renal function and AKI are considered
• Review insulin safety, glucose monitoring and hypoglycaemia or ketone risk recognition
• Identify variation in medicine-specific review, escalation and discharge communication
• Generate governance-ready and ARCP-ready evidence

• Anonymous case identifier
• Inclusion / eligibility decision
• Anonymised biodata (age band, recorded sex/gender, care setting, assessment context)
• Documented diabetes type and diabetes medicines in use
• Clinical area / location and optional specialty / service
• Sixteen diabetes medication review criteria (met / not met / not applicable)
• Free-text learning points (this free ready-built project uses a fixed set of fields)

• Live dashboard
• Audit report (Word)
• Executive summary (Word)
• Excel workbook
• PowerPoint presentation
• Conference poster
• ARCP evidence summary

• Designed to use anonymised or pseudonymised audit identifiers.
• This tool supports, but does not replace, clinical judgement.
• Local policy, formulary and specialist advice should be followed.
• Organisations remain responsible for local governance arrangements.
• This tool supports, but does not replace, clinical judgement. Follow local policy, formulary, renal guidance and diabetes specialist advice.
• This is an audit tool, not a prescribing protocol: withholding, adjusting and restarting rules remain locally configurable.
• Use anonymous case identifiers only — never patient-identifiable information.

Supporting guidance from the Lazomis QI Resource Library. Authoritative clinical standards referenced by this project remain separate.

• Quality ImprovementHow Many PDSA Cycles Does a Quality Improvement Project Need?This guide explains the iterative nature of PDSA cycles and offers practical advice for determining the appropriate number of cycles needed for effective quality improvement in NHS settings.
• Quality ImprovementPlanning Effective PDSA Cycles for Quality ImprovementThis guide provides a practical, step-by-step approach to planning effective Plan-Do-Study-Act (PDSA) cycles for quality improvement initiatives within the NHS, focusing on robust design and learning. It covers essential considerations from defining your aim to anticipating challenges, helping teams systematically test changes.
• Clinical GovernanceIntegrating Quality Improvement into Clinical Governance FrameworksThis article explores the vital relationship between Quality Improvement (QI) and Clinical Governance within the NHS, demonstrating how they are two sides of the same coin when aiming for continuous, systematic improvement in patient care.
• Quality ImprovementAvoiding Common PDSA Pitfalls: A Guide for Effective QIThis guide addresses frequent errors in planning, doing, studying, and acting (PDSA) cycles, offering practical advice to enhance the effectiveness of your Quality Improvement initiatives within the NHS.