The incidence of Gestational Diabetes Mellitus (GDM) in the Fairfield LGA has been on the rise, resulting in an increasing demand for diabetes services. Having experienced a 20% increase in the total number of services attended by women with GDM in just one year, Fairfield Hospital’s Diabetes Clinic was stretched beyond capacity.
Clinical Nurse Consultant, Jenny Wright and her team at the clinic knew that they needed a new and innovative approach to service delivery.
“We needed to think of new ways to improve the service we were offering while ensuring the needs and safety of our patients were not compromised,” says Jenny.
With that in mind, Jenny turned to the research. Conducting an exhaustive literature review into the use of technology to assist with increasing workloads and improving service delivery, Jenny found a pilot study in the UK which formed the basis of Fairfield Hospital’s own pilot.
In the Fairfield Hospital study, 163 women were taught how to take their blood-glucose readings at home using a blood-glucose monitor. Using bluetooth technology, the readings were synced to a smartphone app which had previously been set up at the clinic. The readings were then automatically uploaded to a secure server where clinicians at the clinic could review the data in real-time and respond quickly to any abnormal readings.
The study, one of the first of its kind in Australia, aimed to safely reduce the number of clinic visits by women with GDM. Traditionally, women with GDM needed to present to the diabetes clinic every one or two weeks. With the majority of women diagnosed early in their second trimester, this meant having to attend 10-14 diabetes-related clinical visits during their pregnancy. However, with the use of technology, participants in this study had their visits reduced from weekly to four-weekly for the majority of their pregnancy (at 36 weeks they returned to weekly visits).
This reduction in clinic visits not only alleviated the workload at the clinic but findings of the study showed that there were no negative pregnancy outcomes.
“The evidence that we collected showed that the trial was safe and effective. The women in the pilot study required fewer diabetes-related clinic visits with no increase in adverse pregnancy outcomes when compared to the control group,” Jenny explains.
In addition, the intervention empowered women with GDM to become active participants in their health care.
“It makes you more accountable knowing someone is watching,” said one participant.
With the first pilot deemed a success, Jenny and her team are about to commence a second pilot with women of non-English speaking background.
If successful, this model of care could be implemented at other sites in the SWSLHD and potentially, more broadly.