SC Acute Inpatient Glycemic Management’s (IGMP)

Needs Assessment

Sponsors: Diabetes Initiative of South Carolina (DSC) South Carolina Organization of Nurse Leaders (SCONL) South Carolina Association for Healthcare Quality South Carolina Hospital Association‘s "Every Patient Counts" Initiative

American Heart AssociationBlueCross BlueShield of South CarolinaThe Carolinas Center for Hospice and End of Life Care The Carolinas Center for Medical Excellence Diabetes Initiative of SCLifePoint, Inc.Mothers Against Medical ErrorsPalmetto APICPalmetto Healthcare Liability Insurance ProgramQualis HealthSC Area Health Education Consortium SC Association for Healthcare QualitySC Chapter of the American Society for Healthcare Risk Management

SC Node SC Node Supporting Supporting

PartnersPartnersSC Healthcare AssociationSC Joint Underwriting AssociationSC Medical Association SC Nurses AssociationSC Office of Rural HealthSC Organization of Nurse LeadersSC Patients’ Compensation FundSC Pharmacy AssociationSC Primary Health Care AssociationSC Society of Health-System PharmacistsSC State Budget & Control Board Office of Research & StatisticsSC State Budget & Control Board Insurance Reserve FundSCHA-SCMA Senior Medical Leadership Council

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SURVEY SUMMARY(DECEMBER 2008)

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Respondents

63 hospitals sent invitation

33 hospitals opened survey

32 hospitals completed survey

Response Rate = 50.8%

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Current Status in implementing an inpatient glycemic management program (IGMP)

5N=33 hospitals answered this question

Current Status in implementing an inpatient glycemic management program (IGMP) by large/urban and small/rural hospitals

6N=33 hospitals answered this question

IGMP Elements in Place

N=25 hospitals answered this question7

Policies in Place?

Hospital-wide glycemic management

ICU glycemic management

N=32 N=318

By Large/Urban and Small/Rural

% Hospital-wide glycemic management

% ICU glycemic management

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Glycemic Management program

Formed a team Barriers that need addressing

N=32 N=3110

Hospital formed a Glycemic Management Program by Small/Rural and Urban/Large Hospitals

11N=32 hospitals answered this question

Correction insulin (sliding scale) used by itself

N=33 hospitals answered this question12

If used in your facility, what area is it found?

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All areas where insulin IV infusion protocols may be used

N=32 hospitals answered this question14

All areas where diabetes order sets for SubQ basal-bolus administration may be used

N=32 hospitals answered this question15

All areas where hypoglycemia policy/protocol may be used

N=32 hospitals answered this question16

All areas where an insulin pump patient/protocol may be used

N=29 hospitals answered this question17

Facility use a proprietary vendor program for IV infusion protocols

N=33 hospitals answered this question18

Facility use a proprietary vendor program for IV infusion protocols by Small/Rural and Urban/Large Hospitals

19N=33 hospitals answered this question

Type of proprietary vendor program for IV infusion protocols that Hospitals are using

Proprietary Vendor Program

Endotool

Glucomander

Alaris

MDN-CGS

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Insulins

Devices currently used All insulins on your fomulary

N=26 N=3221

OUTCOME MEASURES

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Outcome Measures to determine impact of your program

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Useful “tools” for your IGMP

N=32 hospitals answered this question24

Interested

Participating in a IGMP Collaborative

N=30 N=29

Sharing de-identified data in IGMP Collaborative

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Top Priorities

Standardized protocols/policies/order sets

Education initiatives

Outcomes/Metrics

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Recommendations

DSC (and partners) Add sessions on inpatient glycemic

management (such as best practices and policies) to DSC Educational Programs

Support development & implementation of a public domain calculator

SCHA Develop protocol/policy samples using experts Design & develop content for education using

experts Provide “train the trainer” program to use

developed content at local sites Develop/maintain web-site with tools

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SURVEY QUESTIONS

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Questions

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Please describe your current status in implementing a formal or structured inpatient glycemic management program.

Please indicate if the following elements are in place with your program. Do you have hospital-wide glycemic management polices in place?

Do you have ICU glycemic management policies/protocols in place?

Please check all areas in your hospital where insulin IV infusion protocols may be used:

Please check all areas in your hospital where diabetes order sets for SubQ basal-bolus administration may be used:

Is correction insulin (sliding scale) being used by itself?

If a hypoglycemia policy/protocol is used in your facility, please check all areas where it may be found:

If an insulin pump patient policy/protocol is used in your facility, please check all areas it may be used:

Please describe the involvement, if any, of patients in your insulin pump patient policy/protocol.

Questions

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Has your hospital formed a Glycemic Management Team?

Please identify the barriers your facility needs to address in order to advance a glycemic management program: (check all that apply)

What outcome measures do you use, or plan to use, to determine the impact of your program?

Does your facility use a proprietary vendor program for IV infusion protocols? Please check all insulins that are on your formulary:

Which devices are currently being used?

What "tools" would be useful as you move forward with your glycemic management program?

Is your hospital interested in participating in an Inpatient Glycemic Management Collaborative sponsored by SCHA, DSC, SCONL, and SC AHQ? Is your organization willing to share de-identified data with the other hospitals in an Inpatient Glycemic Management Collaborative?

In your opinion, what should be the three top priorities of an Inpatient Glycemic Management Collaborative in our state?

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