…Work It with the SHM Workbook

The Society of Hospital Medicine (SHM) recognizes the importance of successful glycemic control in hospitalized patient populations as well as the unfortunate gap in best practice and standard procedures in most hospitals today.  Further, it recognizes that hypoglycemia is a common outcome of current attempts to control hyperglycemia in inpatient settings.

SHM provides a step-by-step guide for addressing these issues in its comprehensive workbook, “Improving Glycemic Control, Preventing Hypoglycemia and Optimizing Care of the Inpatient with Hyperglycemia and Diabetes” developed by the organization’s special Glycemic Control Task Force.

While implementing such a program calls for time and effort, glycemic automation tools can significantly pare down these demands.  For example, EndoTool simplifies data collection and provides many of the algorithms and protocols discussed below.  While offering a full range of features, EndoTool supports a sophisticated inpatient glycemic control program for individualized treatment.

According to the workbook, the following components are key to ensuring the success of a hospital hyperglycemia control program:

  • Institutional support for the initiative enterprise-wide through investment of time, technology and personnel.
  • A multidisciplinary team or steering committee to spearhead the effort to implement best practices, reach glycemic targets and report on the initiatives to key medical staff.
  • Data collection and reliable metrics that become the basis of reports on insulin use patterns, patient hyper- and hypoglycemia, and glycemic control.
  • Specific aims, or goals for the program that are realistic and measurable.
  • Standardized insulin order sets predicated on evidence-based insulin use in critical and non-critical care settings.
  • Algorithms, policies, and protocols that support the safe and effective use of these order sets. They should be tested for reliability and implemented hospital-wide. Algorithms, policies, and protocols should focus on: patient-specific insulin dosage calculation, transitioning from insulin infusion to subcutaneous delivery, patient care in a full range of settings, optimizing data collection and reporting strategies, nutritional and dietary support, continuity of care and more.
  • Comprehensive education and certification programs for mastering general and institution-specific glycemic control guidelines.

For more information and to download the toolkit, visit the SHM website.