Discharging Wisely


30 June 2018

Funding Amount:





Melbourne Macedon Ranges Yarra Moonee Valley Darebin Maribyrnong Hobsons Bay Wyndham Brimbank Moorabool Melton Hume Merri-bek


As the burden of diabetes continues to increase, the need to deliver care in the most appropriate setting becomes more important, including ensuring that hospital services are accessible in a timely manner when required. In this context the Discharging Wisely project sought to address issues stemming from greatly increasing demand on the Western Health diabetes clinic at Sunshine Hospital. New approaches were implemented to increase the capacity of the clinic to see new referrals and better manage existing resources.

The project:

  1. Developed criteria-based discharge from the diabetes clinics.
    • Clear thresholds for probable discharge were developed and implemented following consultation with Western Health endocrinologists.
    • A diabetes educator reviewed clinic lists and identified patients that met the criteria.
    • An alert card was used to notify clinicians which patients were recommended for discharge.
  2. Established a new attendance policy to ensure that clinic resources were used most appropriately.
  3. Produced communication tools and information sheets to provide GPs receiving discharged patients with appropriate and relevant support at the critical time of transition of care.
    • This included an electronic management plan to support GPs to manage patients discharged from the clinic, with ongoing management advice


The project demonstrated that the implementation of discharge criteria in a specialist outpatient clinic can result in an increased rate of discharge, and that this increase in discharge is linked to providing greater opportunity for new patients to attend the clinic and receive specialist advice

  • The number of new patient appointments at outpatient clinics doubled between July 2017 and June 2018.
  • The rate of discharge from the hospital to GP care doubled between June 2018 and July 2017.
  • There was a small improvement in the Did Not Attend rate.
  • The waitlist for diabetes clinics decreased substantially between July 2017 and June 2018, while referrals increased significantly over this timeframe.

A GP education evening was held at Sunshine Hospital to inform primary care clinicians and diabetes educators of new therapies and technologies for improving diabetes care.

The project team also visited six GP practices to conduct tailored education sessions to GPs and clinical staff.

Services involved