Infection control best practices borrowed to improve inpatient glucose management

One in four hospital patients has a diagnosis of diabetes, and when their diabetes isn't well managed in the hospital, it can lead to longer, more expensive hospital stays. To combat this issue, Johns Hopkins physicians borrowed a page from healthcare-associated infection control models.

The model was presented in a study published in The Joint Commission Journal on Quality and Patient Safety co-authored by Nestoras Mathioudakis, MD, a Johns Hopkins endocrinologist, and Peter Pronovost, MD, the director of Baltimore-based Johns Hopkins' Armstrong Institute for Patient Safety and Quality.

In the article, Dr. Mathioudakis said the team-based approach many hospitals now take to focus on patient safety can be used in the field of inpatient glucose management.

"There's a significant variability in provider knowledge about glucose management," said Dr. Mathioudakis. "A glucose management team would focus specifically on keeping blood sugar levels under good control."

Other ideas from the quality improvement playbook can also be used in this field. Some recommendations from the model include:

  • Centralized glucose management programs
  • Standardized policies on insulin pump use and hypoglycemia management
  • Computerized order sets
  • Clinical decision support tools
  • Prescriber education
  • Pharmacist-driven interventions
  • Nutrition interventions

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