Los Angeles-based Cedars-Sinai is refining its approach to inpatient diabetes management by integrating standardized protocols, technology and multidisciplinary teams aimed at reducing complications and readmissions.
Managing high blood sugar among hospitalized patients can be complex, as many admitted with diabetes are often being treated for other conditions, and those without diabetes can develop high blood sugar due to illness, surgery or other stressors.
“Patients are not usually hospitalized because of diabetes, but because of another condition, so they are not admitted in one specific area of the hospital,” Roma Gianchandani, MD, medical director of diabetes quality and vice chair of quality and innovation at Cedars-Sinai, said in a March 19 news release. “It’s important that specialized protocols and programs that prioritize diabetes care are available hospital-wide.”
Dr. Gianchandani, who co-authored a recent Annals of Internal Medicine study on best practices for managing high blood glucose, leads Cedars-Sinai’s interdisciplinary efforts to improve diabetes care throughout the hospital.
Four notes on their approach:
- Cedars-Sinai diabetes experts have developed hospital-wide nursing policies for blood sugar monitoring, insulin administration and hypoglycemia management to ensure consistency in care.
- To simplify IV insulin administration for nurses, the hospital employs a computerized insulin dosing tool. Insulin pumps and glucose sensors are also integrated into patients’ EHRs to support appropriate post-discharge care.
- The hospital has also created a pharmacist-led surveillance program, where a pharmacist reviews abnormal blood sugar levels daily and collaborates with physicians to adjust medication orders as needed.
- Clinical teams are also evaluating AI algorithms to predict blood sugar fluctuations and enable proactive intervention.
