How Novant Health improved patient safety via collaboration, innovation: 4 notes

Through strategic collaboration and the implementation of best practice technology, hospitals can improve care and outcomes for glycemic patients, even amid the pandemic. 

During Becker's Clinical Leadership and Pharmacy Virtual Forum, experts discussed the importance of strategic collaboration and innovation related to glycemic management during the Feb. 25 featured session "Collaborate to Innovate. How Clinical Leadership Drives Practice Change to Optimize Patient Safety Outcomes."   

The speakers were:

  • Cathy Rolih, MD, clinical physician executive of the Diabetes Center of Excellence and co-chair of the Diabetes Best Practice Exchange Team at Charlotte, N.C.-based Novant Health
  • Jordan Messler, MD, executive director of clinical practice at Glytec 

Four key takeaways: 

1. Diabetes management in hospitals is common, costly and further complicated by the pandemic, Dr. Messler began. Numerous challenges can prevent safe glycemic management, such as antiquated one-size-fits-all approaches like sliding scale and paper protocols, minimal data, and glycemic management issues siloed by administration. 

2. About 25 percent of Novant Health's inpatients are living with diabetes, according to Dr. Rolih. The 18-hospital system created a dashboard for tracking COVID-19 patients with diabetes and found diabetes was the most common comorbidity, with 30 percent of Novant's COVID-19 patients living with diabetes and about 47 percent of COVID-19 patients with diabetes dying. High dose dexamethasone improves survival for COVID-19 patients and was adopted across Novant Health, Dr. Rolih said. However, the steroid can exacerbate hyperglycemia in all patients. Research nationwide was inconsistent, so Novant assembled a cross-functional work group to design guidelines using its existing glycemic management tool, Glucommander, part of Glytec’s eGlycemic Management System, and leveraging the support of Glytec’s clinical experts.

3. The key to Novant Health's success over the last year has been both collaboration and innovation, Dr. Rolih said. The multidisciplinary team of experts launched in April 2020 included hospitalists, critical care specialists, pharmacists, dieticians, nurses, endocrinologists, diabetes education specialists, data analysts, administrators and Glytec partners. The team shared key learnings and experiences, accelerating change across the system. Novant piloted their developed guidelines with 51 consecutive COVID-19 inpatients, 22 of whom were diagnosed with diabetes. The majority of glucose values in patients were less than 250 by the third day of treatment, with only one significant hyperglycemia episode and no inpatient mortality. Novant is refining the protocols so it can roll the guidelines out across all 18 hospitals. Having a group of highly passionate individuals willing to work above and beyond their traditional job roles was, and still is, critical to the system's ability to adapt and respond to the pandemic crisis, Dr. Rolih concluded. 

4. Glytec's eGlycemic Management System (eGMS) enables collaboration and innovation with its EHR-integrated glycemic management software, Dr. Messler explained. eGMS’s insulin titration module, Glucommander provides personalized insulin dosing decisions at the point of care. Hosted in the cloud, the platform can be implemented and upgraded remotely. Glytec provides metrics back to all sites to monitor changes and support continued improvement, which engages executive leaders and clinical specialists from various disciplines to measure glycemic management and patient safety outcomes.  

For more on Glytec, click here. To view the full session, click here

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