Objective

Investigating the impact of implementing EndoTool IV (ETIV), a computerized insulin dosing algorithm, in the treatment of diabetic ketoacidosis (DKA) across a 7-hospital system in Central Pennsylvania.

Setting

UPMC Harrisburg hospital, part of the larger UPMC seven hospital system in Central Pennsylvania. Two distinct time periods were utilized for comparison of outcomes: September to December 2021, representing the pre-implementation phase of the EndoTool IV (ETIV) computerized insulin dosing algorithm, and September to December 2022, reflecting the post-implementation phase.

Results

This study highlights the potential benefits of using EndoTool IV to manage complex conditions like DKA, with a focus on both clinical and economic outcomes.

• Incidence of hypoglycemic events reduced from 2.26% to 0.35%, a significant decrease of approximately 84.5%.
• The number of blood glucose checks decreased by 55%.
• Average hospital length of stay decreased from 5.1 to 4.5 days.
• Time required for insulin infusion decreased from 37.2 hours to 35.41 hours, a reduction of 1.79 hours approximately.

Conclusions

• Clinical Improvements: EndoTool IV led to fewer hypoglycemic events, fewer glucose checks, and shorter infusion times.
• Financial Impact: While there was no significant reduction in ICU charges, EndoTool IV shows promise in improving clinical outcomes for DKA patients.
• Future Directions: Further subgroup analysis is being conducted to explore the results in more detail.