Creating a Winning Team to Advance Diabetes Care and Improve Outcomes

There’s a common saying, “teamwork makes the dream work.” Healthcare is truly a team sport. With increasing comorbidities and specialization of care, it takes a team of healthcare professionals to deliver patient-centered care. Working as an effective team in both the inpatient and outpatient setting not only has immediate implications for the safety and quality of care delivered, but it is also critical for the continued improvement and advancement of care.

In the case of  inpatient glycemic management, hospitals are recognizing the complex web of processes involved as they look to reduce rates of hyperglycemia and hypoglycemia, adopt best practices of care, and improve the overall management of diabetes care. However, no one person should try to go at this alone. To achieve these goals, it will require a team. One of the core elements to a glycemic optimization program is the development of a multidisciplinary glycemic management committee.

A glycemic management committee establishes glycemic control as a system-level priority. The group serves as champions and change agents for inpatient diabetes care guiding the development and implementation of policies and procedures, standardized protocols, educational interventions, and clinical decision tools through the use of glycemic performance measures and metrics across the hospital.

To start or enhance your Glycemic Management Steering Committee, here are ten tips to follow:

1. Be Proactive. Don’t wait until you have an issue that needs to be addressed immediately to start your glycemic optimization program. By getting a head start in forming your committee, you garner better insights into performance and outcomes to layout an effective and comprehensive game plan.
2. Have Representation from All Impacted Departments. The groups are generally led by a diabetes clinician and include multidisciplinary representation from the following departments: physicians (endocrinologist/lead hospitalist/house staff), midlevel providers, nurse educators, pharmacists, dietitians, point of care testing/lab specialists, nursing, patient safety officer/quality and hospital administration representative. At a minimum, the group should include “champions” from administration, nursing, medicine and pharmacy.
3. Know Your Data. As Dr. Sandy Fogel, Medical Director of OR Services at the Carilion Clinic in Roanoke Virginia, stated in a recent blog, “if you don’t know where you are, you don’t know where to go, and you don’t know how to get there.” One of the first tasks of the committee will be to decide on key quality metrics that are related to glycemic management in your facility. Each process improvement project may need specific metrics to quantify change, and keeping your eye on the overall goals at all times will help your committee know when they’re making a difference. Get to know the benchmark metrics used widely now and those planned for the future, including proposed CMS quality measures.
4. Establish Clear Roles and Responsibilities. While everyone may be aligned on what needs to be done, not everyone may be stepping up to the plate to complete the action item. Having a clear action plan with the responsible roles will help drive efficiency.
5. Set SMART Goals: Establish goals for the committee that are specific, measurable, achievable, relevant, and time-based.
6. Evaluate How to Effectively Incorporate the Use of Technology. To help achieve your goals, consider how technology can help. Whether it’s meeting the benchmarks like the proposed CMS glucose control measures, standardizing care to improve patient safety, or improving workflow to enhance nurse satisfaction, technology like EndoTool has proven to help. The glycemic management committee should be responsible for identifying and evaluating solutions that will assist in their quality improvement and help meet their goals.
7. Ensure There is Reliable Execution of the Game Plan. You may have SMART goals and clear responsibilities established, but you will only be successful if there is an expectation for reliable execution. At each meeting, establish next steps and a means to track and communicate progress between meetings.
8. Schedule Regular Meetings. Set up a standing meeting to make sure scheduling doesn’t become a barrier to your success. The group should meet on a regular basis to discuss progress, share best practice and develop new strategies to address barriers to implementation.
9. Maintain Optimistic Attitudes. Optimistic attitudes and expectations of success lead to more successful and efficient change management. For your committee, try to engage clinical leaders who have a voice in leadership, are trusted among other teams within the hospital, and have some stake in the game when it comes to insulin administration for hyperglycemia. These leaders will be key in driving an optimistic approach to quality and change management.
10. Commit to Continued Advancement. The change your glycemic management committee may be trying to make is hard, but what’s even harder is seeing all your efforts reversed as soon as you’ve finished and reached your goal. To make your changes stick, it requires continued review and assessment.

For more information on how to establish a glycemic management committee at your organization, contact our team.  Monarch provides a comprehensive guide with sample agendas, roles and responsibilities, and benchmarking metrics. Additionally, our team is able to conduct a gap analysis to help you identify significant process and practice improvements to take the first step in successful change management.