A Community Hospital Conquers Hyperglycemia and Becomes a Best Practice Site
Concerned about its inability to stabilize glucose levels in its most acutely ill patients, Wilson Memorial Hospital, a 71-bed community hospital, engaged a well-known glycemic benchmarking service. The service found the hospital in the lowest quartile of benchmarked hospitals nationwide. Knowing that hyperglycemia correlates with poor clinical outcomes and mortality in patients with and without a history of diabetes, naturally the Wilson staff was disturbed.
Two years prior to this, Wilson had abandoned its pre-printed sliding insulin scale in favor of order forms with four standard algorithms for blood glucose control. However, internal approvals for changing this protocol became an unwieldy process in and of itself. Moreover, physicians felt the system was not sophisticated or flexible enough to appropriately meet glycemic goals in their more challenging cases. In short, the labor-intensive process, which involved frequent blood draws and dosing adjustments, simply did not deliver satisfactory results for the time invested.
As a result, a multi-disciplinary committee examined alternative paper algorithms and three competing digital glucose monitoring systems. It found that EndoTool was the only system able to individualize dosing to each patient’s unique physiology and response to insulin, while alternative solutions delivered results similar to traditional paper protocols.
During the first month with preliminary use on 25 patients, EndoTool achieved significant improvements with decreases in both hyperglycemia and hypoglycemia.
The third quarter report from the glycemic benchmarking program as fully implemented were equally impressive as seen below.
|Before EndoTool||After EndoTool|
|Housewide||183.9 mg/dL||162.2 mg/dL|
|ICU||184.1 mg/dL||147.1 mg/dL|
|Medical Surgical Floor||183.8 mg/dL||165.4 mg/dL|
While deployed hospital wide, all patients on EndoTool achieved two blood-glucose readings under 150 mg/dL within two hours and the clinical staff said that transitioning to subcutaneous insulin was far simpler with EndoTool.