Assessing Inpatient Glycemic Control: What Are the Next Steps?
J Diabetes Sci Technol Vol 6, Issue 2

Glucometrics has been defined as the “systematic analysis of inpatient blood glucose data.” The rationale for tracking and reporting inpatient glucose control statistics is based on several factors.

First, there are clinical scenarios where better glucose control has been shown to improve patient outcomes, and hospitals will want to know if hyperglycemia is managed adequately in those population subsets.

Second, several U.S. quality improvement organizations have recognized the value of better glycemic management; some have developed educational resources to help institutions achieve better inpatient diabetes and hyperglycemia care.

Third, a recent survey of U.S. hospitals indicated that many have either fully or partially implemented inpatient diabetes quality improvement programs and as these initiatives go live, they will require metrics by which to assess their impact on glucose control. Yet, nearly one-third of these hospitals have indicated that they had no metrics in place to assess the outcomes of their glucose management programs.

Finally, pay-for-performance requirements are beginning to emerge that are applicable to inpatient diabetes management. Reports on the status of inpatient glucose control in large samples of hospitals are now available.

Which Metric Should be Used? more >

Glucose Meter Update
Lifescan customers, follow these tips to smooth your transition to a new meter
Advance for Administrators of the Lab,

By Bob Kaplanis, PBT, MT(ASCP)
 
Banner Hospital System are one of the many Lifescan customers that must have a new glucose meter in place by 3/31/2013 and I anticipated that our organization would in the middle of implementing our next glucose meter by February 2012. Instead we began contract negotiations then and hope to finish implementations by December in our 22 hospitals that reside in 7 states.

I had a discussion with Lifescan at the beginning of February and learned they are only seeing 1% of their 1,000 customers switch to a different vendor each month. If you are one of the many Lifescan customers that face the same timeline, and have not made your decision yet, you may be scrambling at the end. There will be many facilities putting pressure on the glucose meter manufacturers (i.e Abbott Diabetes Care, NOVA Biomedical, Roche Diagnostics) to get them converted by the deadline.

The following steps can be completed in a month and will likely narrow your choices:

Do you currently use an interface/data management system? If so, not all manufacturers are interfaced to the different interface choices available.

Do you have a large number of operators that will need to be entered into the database for the new glucose meter?Discuss possible glucose meter choices with your, or alternative interface/data management provider(s) (i.e Abbott PWeb, Telcor, RALS) to learn of any features you currently rely on that will not be available.
more >

Update on Inpatient Glycemic Control in Hospitals in the United States
Christine M. Swanson, MD; Daniel J. Potter, MA; Gail L. Kongable, MSN, FNP; Curtiss B. Cook, MD

Many quality improvement organizations have been focusing on improving the management of inpatient hyperglycemia. A recent survey of hospitals in the United States demonstrated that the frequencies of hypoglycemia and hyperglycemia were the top 2 metrics of interest to hospitals, and many hospitals have either fully or at least partially implemented inpatient diabetes quality improvement programs. Several quality improvement organizations are promoting the need for better inpatient glycemic control and have developed educational resources to help hospitals achieve better management. Finally, in certain clinical scenarios, better glucose control has been shown to improve patient outcomes.

Debate may continue over what glucose targets should be achieved; however, because of the national focus on inpatient glycemic control, hospitals increasingly may want to track glucose levels in their patients.
 

Glucose targets for both critically ill and noncritically ill patients have been proposed. For instance, the recommended target glucose range is 140 to 180 mg/dL for critically ill patients, and a random glucose level of less than 180 mg/dL has been recommended for noncritically ill patients. Thus, as hospitals continue to develop and implement inpatient diabetes glycemic control programs, national benchmarking will allow institutions to compare their performance against recommended standards.

We have been reporting data on glucose control from a progressively larger number of US hospitals; these data have provided insight into the status of inpatient hyperglycemia and hypoglycemia. We can now provide an update from more than 500 hospitals—the largest sampling to date—and further describe differences in glucose control stratified by hospital characteristics. Methods... more >

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Last updated: 05/17/2012 Questions or corrections: editor@pointofcare.net.© 2011 Medical Automation Systems, Inc.

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