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Published on: June 11, 2012
Decision Support Tool to Improve Glucose Control Compliance After Cardiac Surgery
Vitali Fedosov1, Mikhail Dziadzko1, Joseph A Dearani1
1Vitali Fedosov is Research Fellow, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota. Mikhail Dziadzko is Research Fellow, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota. Joseph A. Dearani is Professor of Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota. Daniel R. Brown is Professor of Anesthesiology, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota. Brian W. Pickering is Assistant Professor of Anesthesiology, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota. Vitaly Herasevich is Associate Professor of Anesthesiology and Medicine, Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905 (herasevich.vitaly@mayo.edu).
Abstract:
Hyperglycemia control is associated with improved outcomes in patients undergoing cardiac surgery. The Surgical Care Improvement Project metric (SCIP-inf-4) was introduced as a performance measure in surgical patients and included hyperglycemia control. Compliance with the SCIP-inf-4 metric remains suboptimal. A novel real-time decision support tool (DST) with guaranteed feedback that is based on the existing electronic medical record system was developed at a tertiary academic center. Implementation of the DST increased the compliance rate with the SCIP-inf-4 from 87.3% to 96.5%. Changes in tested clinical outcomes were not observed with improved metric compliance. This new framework can serve as a backbone for development of quality control processes for other metrics. Further and, ideally, multicenter studies are required to test if implementation of electronic DSTs will translate into improved resource utilization and outcomes for patients.
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