Implementing and evaluating a multicomponent inpatient diabetes management program: Putting research into practice

Miguel Munoz, Peter Pronovost, Joanne Dintzis, Theresa Kemmerer, Nae Yuh Wang, Yi Ting Chang, Leigh Efird, Sean M. Berenholtz, Sherita Hill Golden

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components: The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidencebased inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes: Overall the average patient-day-weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion: Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. Copyright 2012

Original languageEnglish (US)
Pages (from-to)195-206
Number of pages12
JournalJoint Commission Journal on Quality and Patient Safety
Volume38
Issue number5
DOIs
StatePublished - May 2012

ASJC Scopus subject areas

  • Leadership and Management

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