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.