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Updated: May 28, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Improving outpatient diabetes care.

Susan Kirsh1, Michael Hein, Leonard Pogach

  • 1Louis Stokes Cleveland Veterans Affairs Medical Center, OH 44106, USA. Susan.Kirsh@Va.Gov

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality
|October 28, 2011
PubMed
Summary
This summary is machine-generated.

Veterans Health Administration outpatient clinics with better diabetes care reported strong teamwork and dedicated time for patient management. These best practices will be shared to improve care across the VHA.

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Last Updated: May 28, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

  • Health Services Research
  • Diabetes Management
  • Healthcare Quality Improvement

Background:

  • Diabetes affects over 20% of patients within the Veterans Health Administration (VHA).
  • Disseminating best practices in outpatient diabetes care is crucial for improving patient outcomes.
  • Identifying factors associated with high-performing diabetes care is essential for quality improvement initiatives.

Purpose of the Study:

  • To identify best practices in outpatient diabetes care within the VHA.
  • To determine factors associated with the development and implementation of these best practices.
  • To inform the dissemination of successful strategies across the VHA.

Main Methods:

  • Utilized a national VHA diabetes registry (2008 data) to stratify facilities into high, mid, and low performers based on A1c control.
  • Conducted semistructured telephone interviews with staff at various performance levels.
  • Performed site visits to gain deeper insights into clinical operations and team dynamics.

Main Results:

  • Low-performing sites identified lack of physician-nurse teamwork and insufficient preparation time as barriers.
  • High-performing sites reported supportive clinical teams, efficient work-sharing, and dedicated time for non-face-to-face patient care.
  • Innovative practices tailored to local needs were observed at better-performing facilities.

Conclusions:

  • Significant differences in clinical performance and practice patterns exist among VHA outpatient facilities.
  • Supportive clinical teams, efficient workflows, and allocated time for care are key factors in high-quality diabetes management.
  • Best practices identified will be disseminated as part of the VHA Patient-Centered Medical Home model implementation.