Improving Surgery Outcomes for People With Diabetes
Dec. 16, 2021
People with diabetes face a number of health risks. They are more likely to develop heart, gum or kidney disease. Surgery also poses a risk.
“People with diabetes who do not have good sugar control have poorer wound healing and increased risk of infection after surgery,” said Dr. Shawn Stinson, BlueCross BlueShield of South Carolina’s senior vice president for health care innovation and improvement.
Diabetes Free SC (DFSC) recently announced a program to address this issue. The South Carolina Surgical Quality Collaborative (SCSQC) Diabetes Initiative aims to get people with diabetes, or who are at risk of diabetes, as healthy as possible before planned surgery.
What is the SCSQC?
The SCSQC is funded by the BlueCross BlueShield of South Carolina Foundation. The goal is to have hospitals share information to improve surgical outcomes. Eight hospitals were part of the initial program in 2015.
“Through this program, we were able to identify areas of improvement opportunities at participating hospitals,” Stinson said. “The data was taken from the surgeons’ records, so it was trusted data for them. This data was then shared with the SCSQC.”
Three hospitals are participating in the new diabetes program:
- McLeod Medical Center, Florence
- Medical University Hospital, Charleston
- Regional Medical Center, Orangeburg
Why focus on patients with diabetes?
“People with diabetes are more likely to need surgery. Their underlying conditions, which often are undetected, can negatively impact surgical outcomes and recovery. Careful preadmission evaluation and planning, which we call ‘pre-habilitation,’ can greatly reduce these risks,” said Dr. Timothy Lyons, executive medical director of DFSC.
Support from DFSC will allow participating hospitals to enlist teams focused on diabetes control before, during and after surgery. These teams will work with the patients’ existing medical teams. These teams will include a program leader who has experience working with people with diabetes, and endocrinologist and a diabetes educator. The teams are encouraged to access specialist support like cardiology, ophthalmology, psychology and the patient's social support network.
“It was a natural next step to introduce diabetes control to the collaborative,” Stinson said. “If we are really going to make an impact on surgical outcomes, we need to focus on diabetes. Poor sugar control leading up to surgery plays a key role in reducing wound healing and increasing infection rates.”
Individual care for improved outcomes
Each patient has his or her own pre-habilitation needs. Care will be adapted for each patient. For example, rural patients will have access to telehealth services. Some goals are the same for everyone. Controlling blood sugar and addressing complications and existing health conditions will be part of each patient’s care plan.
“Proper diabetes management is a lifelong need that is not limited to the time of surgery. Therefore, pre-habilitation will include an evaluation of long-term needs, home and social support systems, and psychological well-being,” Lyons said.
This level of care is designed to improve surgical outcomes for people with diabetes and prediabetes. The goal is to help each patient understand diabetes to improve his or her health and quality of life for years.
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