Objective

This retrospective randomized study compares glycemic control and related outcomes before and after implementation of a glucose management software system (EndoTool) in several intensive care and progressive care units as well as the emergency department, all of which previously used a standard paper protocol.

Setting

553-bed not-for-profit health care network.

Results

• Number of hours on an intravenous insulin drip decreased 12.5% with EndoTool, from 23.9 to 20.9 hours.
• Incidence of hypoglycemia <70 mg/dL decreased 80.6% with EndoTool, from 0.036 to 0.007 episodes per patient.
• Incidence of hyperglycemia >180 mg/dL decreased 20.9% with EndoTool, from 0.358 to 0.283 episodes per patient.
• Mean average time to target decreased 24% with EndoTool, from 3.67 to 2.78 hours.
• Mean average blood glucose decreased 6.75 mg/dL with EndoTool, from 193.24 to 186.49 mg/dL.

Conclusions

Implementation of a glucose management software system (EndoTool) promotes a culture of safety and can be expected to reduce costs, as evidenced by a wide array of improvements, including number of hours on an intravenous insulin drip as well as incidence of hypoglycemia, incidence of hyperglycemia, time to target and time in range.