Measures used 1. Improving experience at Antenatal clinic

I. Clinic scheduling with matched appointment

times

II. Virtual clinics and remote monitoring of

blood glucose

2. Improving experience during delivery

I. Reduce monitoring to two hourly blood

glucose

II. Interpret need for IV insulin based on time of

last meal.

Further information contact: Athinyaa.Thiraviaraj@westerntrust.hscni.net

Gestational Diabetes FLOW Pathway

Change ideas tested

The FLOW pathway has engaged with a

wide group of stakeholders as part of

the BigRoom. Most notably women with

Gestational diabetes during pregnancy,

the staff who participate in their care

directly (midwives, obstetricians,

diabetes team, AHPs) and indirectly

(clinical and operational managers,

support staff)

Who is

involved?

Why is this work important?

Gestational diabetes is increasing in incidence

and the service is stretched. The current service

provides safe and effective care, but the

experience for both staff and patients is less

than optimal. The service is currently

overwhelmed with demand. Without change for

improvement, the service is on course to

becoming unsafe in delivering care for women

with diabetes in pregnancy.

Global aim We aim to improve the individual journey of mothers through

the GDM pathway in all GDM clinics and inpatient wards at

Altnagelvin hospital.

1. We will decrease amount of waiting time by 50% from

baseline of 61.5 minutes by end of March 2019

2. We will decrease the number of blood glucose tests offered

to women with diabetes in pregnancy during labour without

compromising safe outcomes by 30% from baseline by end

of March 2019

Specific aims 1. Improving experience at Antenatal clinic

I. Demand per week on Antenatal clinic

appointment

II.Work in progress at clinic

III.Waiting time at antenatal clinic in minutes

2. Improving experience during delivery

I. Number of women with diabetes in pregnancy

giving birth per week in delivery suite

II. Number of blood glucose tests offered in delivery

suite per week

Top 3 achievements

1. Experience of women with diabetes in

pregnancy informing improvements

directly. Patient story at every

BigRoom

2. Increase in connectivity between staff

within pathway. Rediscovery of value

and purpose; re-energized to continue

improvement by empowered staff

3. Discovering new ways of working and

courageously testing. Innovative

models of care like Cloud based

glucose monitoring and video clinics.

Improving experience during delivery reduction in number of blood glucose tests during labour

Improving experience during antenatal clinic reduction in waiting time at joint antenatal diabetes clinic

Team designed leaflet