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Successful Utilization of a Computer-Guided Glucose Management System for a Surgical Care Improvement Project at a Tertiary Care Hospital
Objective
This surgical care improvement project examines the correlation between utilization of a computer-guided glucose management system (EndoTool) and outcomes of national quality initiatives.
Setting
950-bed tertiary care teaching hospital.
Results
- Over a period of four years and 8,078 patients, average time to target blood glucose was 3.38 hours for 180 mg/dL, 3.99 hours for 160 mg/dL, 4.51 hours for 150 mg/dL and 5.35 hours for 140 mg/dL.
- Over a period of four years and and 260,870 blood glucose readings, incidence of hypoglycemia <40 mg/dL was 0.02% and <70 mg/dL was 0.86%.
- Rate of hospital-acquired conditions per 1,000 under HAC-8 (manifestations of poor glycemic control) decreased 61%, from 0.083 pre-EndoTool utilization to 0.032 post-EndoTool utilization, and was sustained at 45% lower than the national average of 0.058.
- Rate of SCIP-Inf-4 compliance (glucose control for cardiac surgery patients) increased 12.5%, from 88% pre-EndoTool utilization to 99% post-EndoTool utilization.
Conclusions
Performance under the HAC-8 and SCIP-Inf-4 measures improve demonstrably in conjunction with use of a computer-guided glucose management system (EndoTool), representing a doubling in cost savings, with outcomes in the top tier of all hospitals nationwide.
Authors
Robert Tanenberg, MD; Sandra Hardee, PharmD; Herbert Garrison, MD; Joseph Elbeery, MD.
Source
Presented at American Diabetes Association Scientific Sessions.
Year
2013
Tags
- Cost Savings
- Healthcare-Associated Infections
- Hospital-Acquired Conditions
- Hyperglycemia Reduction
- Hypoglycemia Reduction
- Length of Stay
- Surgical Site Infections
- Glucose Variability
- Mean Glucose Improvement
- Target Goal Attainment
- Time in Range
- Time on IV Insulin
- Time to Target
- Burn Injury
- Cardiac Surgery
- DKA/HHS Management
- Emergency Department
- Induced Hypothermia
- Intra-op Glucose Management
- Obstetrics/Labor & Delivery
- Pediatrics
- Residual Insulin Adjustment
- BG Check Compliance
- BG Test Reduction
- Nursing Satisfaction
- Protocol Adherence
- Provider Satisfaction
- Workflow Improvements