Introduction: Translation of inpatient glycemic recommendations has been slow to occur. The recent consolidation of two large healthcare systems provided a unique opportunity to harmonize all ordersets and examine the impact on glycemic control.
Methods: A comprehensive revision of glycemic management was accomplished across the health system. All individuals admitted to any of 48 facilities with glucose > 200 mg/dl were included with metrics of glycemic control designed to assess progress across the health system. An extensive multidisciplinary educational program was developed to provide rationale and guidance for providers. Best practice alerts emphasized the use of weight-based basal insulin when not already in place. The present analysis compares annual metrics for the overall health system before (CY 2019) and after (CY 2023) implementation of the program. Target glucose was established as 140-180 mg/dl and hypoglycemia was defined as < 70 mg/dl. Glucose values after achieving initial target were then analyzed for consistency and significance before and after implementation. Results are shown as mean ± SD.* p<0.001.
Conclusion: Implementation of a comprehensive educational and informatics approach to glycemic control which emphasizes the primacy of basal insulin resulted in an increase in orderset use and a concomitant 18% decrease in hypoglycemia
J.N. Clore: None. K. Caluag: None.
