Quality improvement (QI) initiatives work is hard. Getting the results to stick is even harder.
Glycemic management QI programs are no exception. I can tell you from experience that these initiatives often don’t achieve their goals. Or, if they do, they work for only a short time before the effects start to wane.
Even if you have all the necessary ingredients of a good QI initiative — leadership buy-in, provider buy-in, strong education and a multidisciplinary team — the project can still fail.
This is due in part to the high levels of clinical inertia associated with diabetes care. Many stakeholders are hesitant to change the status quo because they fear adverse effects and think changes will make patient care more difficult.
How can quality improvement teams overcome clinical inertia and achieve results that last?
Glytec’s eGlycemic Management System (eGMS) offers a clear and proven path to success for glycemic management QI programs.
GlucoMetrics: You can’t manage what you can’t measure
Healthcare providers and hospital leaders know that the prevalence of diabetes is on the rise and that insulin is a high-alert medication. Still, most hospitals have no dedicated glycemic management team and no standardized way of measuring glycemic management performance.
This was the first problem that Dr. Damon Tanton, MD, an endocrinologist at AdventHealth Orlando, ran into when his team launched their glycemic management QI initiative.
“We can’t change what we don’t know and what we can’t measure,” he told us at the 2020 Diabetes Technology Society Virtual Hospital Diabetes Meeting.
When the team studied the impact of glycemic management at their health system, the results were staggering: compared to those with normal glycemia, patients who experienced hypo- and hyperglycemia had consistently higher length of stay, readmission rates, mortality rates and cost of care.
In fact, the team found that patients who experienced severe hypoglycemia (<40 mg/dl) stayed 6.6 days longer and were 61.5% more likely to be readmitted than patients with normal glycemia. The total cost of severe hypoglycemia to the system was almost $8 million.
Armed with this information, Dr. Tanton’s glycemic management team was able to develop strategies to reduce the impact and frequency of severe hypoglycemia events.
This kind of data is critical for winning buy-in for glycemic management QI initiatives, maintaining communication and accountability and tracking success.
The GlucoMetrics module of Glytec’s eGMS makes gathering this data simple. Built-in reporting and analytics make it easy for teams to track glycemic management performance at the patient, unit, hospital and health system levels.
Despite years of research and established guidelines, many patients with glycemic issues still don’t receive the care they need. Providers often don’t put patients on insulin when they should be and, when patients are on insulin, providers continue to rely on outdated protocols like sliding scale.
Outdated methodologies continue to prevail in glycemic management for a few reasons, including an education gap, a fear of the adverse effects of insulin and a (not inaccurate) perception that paper-based protocols for basal-bolus insulin are difficult and time-consuming.
This is where glycemic management QI initiatives tend to fail. Switching to standard-of-care protocols is often seen as difficult, so providers default to the status quo.
Glytec’s eGMS solves this problem by replacing paper protocols and sliding scale entirely, providing a guided workflow that offers doctors personalized insulin dosing recommendations based on standard-of-care methodologies in both IV and SubQ use cases.
Glucommander's FDA-cleared algorithm automatically adjusts based on real-time patient data and sensitivity to insulin. It's not just safer for patients, it saves providers time - one study found that providers saved 30 minutes per shift compared to manually titrating basal-bolus insulin. The result is that providers get on board with new methodologies quickly; a study of one hospital found that implementing Glucommander helped increase utilization of basal-bolus insulin therapy from just 5% to 96%.
And to return to a previous point, the availability of GlucoMetrics helps QI teams show providers that the new system not only works, but is actually improving patient outcomes.
Glytec has been a partner in many hospitals’ glycemic management quality improvement initiatives, and our technology was designed specifically to support this work. In addition, we supplement and support your team with our clinical, technical, training and project management expertise to assist with change management, implementation, education and more.
In short, we bring high-reliability strategies and proven methodologies to your QI initiatives.
Above, we shared Dr. Tanton’s experience with Glytec’s eGMS. Here’s what a few more of our partners have to say: