Implementation of an insulin therapy protocol: applying the Baldrige approach

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Diabetes Management

Background:

• North Mississippi Medical Center (NMMC) identified patient safety concerns with existing insulin sliding scales.
• Current protocols did not meet evidence-based standards of care for diabetes management.

Purpose of the Study:

• To describe a quality initiative at NMMC using the Baldrige Criteria for Organizational Performance Excellence.
• To develop and implement a standardized insulin sliding scale to improve patient care and blood glucose control.

Main Methods:

• A multidisciplinary team (endocrinologist, nursing, IT, pharmacy) developed a new insulin sliding scale order set.
• The process incorporated literature evidence, clinical knowledge, practitioner feedback, and IT.
• Pilot programs and inservice education for staff preceded full implementation.

Main Results:

• A single, standardized insulin sliding scale was implemented, replacing three previous scales.
• The new protocol targeted blood glucose concentrations of 70-120 mg/dL.
• The Baldrige approach facilitated the project's success.

Conclusions:

• The Baldrige Criteria for Organizational Performance Excellence provided a flexible framework for quality improvement.
• NMMC successfully implemented a standardized insulin therapy protocol, enhancing patient safety and care.