Quality improvement tools to manage emergency callbacks from patients with diabetes in a prehospital setting

Hassan Farhat, Guillaume Alinier, Kawther El Aifa, Khawla Athemneh, Padarath Gangaram, Ricardo Romero, Mohamed Chaker Khenissi, Loua Al Shaikh, James Laughton

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Diabetes is rising at an alarming rate, as 1 in 10 adults worldwide now lives with the disease. In Qatar, a middle eastern Arab country, diabetes prevalence is equally concerning and is predicted to increase from 17% to 24% among individuals aged 45 and 54 years by 2050. While most healthcare strategies focus on preventative and improvement of in-hospital care of patients with diabetes, a notable paucity exists concerning diabetes in the prehospital setting should ideally be provided. This quality improvement study was conducted in a middle eastern ambulance service and aimed to reduce ambulance callbacks of patients with diabetes-related emergencies after refusing transport to the hospital at the first time. We used iterative four-stage problem-solving models. It focused on the education and training of both paramedics and patients. The study showed that while it was possible to reduce the rate of ambulance callbacks of patients with diabetes, this was short-lived and numbers increased again. The study demonstrated that improvements could be effective. Hence, changes that impacted policy, systems of care and ambulance protocols directed at managing and caring for patients with diabetes-related prehospital emergencies may be required to reify them.
Original languageEnglish
Article numbere002007
Pages (from-to)1-9
Number of pages9
JournalBMJ Open Quality
Issue number1
Early online date4 Jan 2023
Publication statusPublished - 4 Jan 2023


  • Quality improvement report
  • 1506
  • Diabetes mellitus
  • Healthcare quality improvement
  • Prehospital care
  • Diabetes Mellitus/epidemiology
  • Humans
  • Emergencies
  • Emergency Medical Services/methods
  • Quality Improvement
  • Delivery of Health Care
  • Adult
  • Ambulances


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