Increasing Frequency of Hemoglobin A1c Measurements in Hospitalized Patients With Diabetes: A Quality Improvement...

Area of Science:

• Healthcare Management
• Diabetes Mellitus Research
• Quality Improvement Methodologies

Background:

• The American Diabetes Association (ADA) guidelines recommend A1c testing for hospitalized patients with diabetes.
• Current practices often fall short of this recommendation, necessitating improved strategies.

Purpose of the Study:

• To evaluate the impact of Lean Six Sigma methodology on increasing the frequency of A1c measurements in hospitalized patients.
• To assess the sustainability of improved A1c testing rates post-intervention.

Main Methods:

• A pre-post intervention study design was used, analyzing electronic health record (EHR) data from January 2016 to June 2021.
• Lean Six Sigma principles were applied to identify and address barriers to A1c testing.
• An intervention bundle included provider education, faster A1c turnaround times, and EHR enhancements.

Main Results:

• A significant increase in A1c measurement frequency was observed post-intervention (61.2% to 74.5%, P < .001).
• The improved A1c testing rate was sustained for over two years.
• Post-intervention, there was an increase in patients seen by the diabetes consult service and a slight increase in length of stay.

Conclusions:

• Lean Six Sigma offers a novel and effective approach to enhance A1c monitoring in hospitalized diabetic patients.
• This methodology can be a valuable tool for community hospitals aiming to improve inpatient diabetes care quality.