Inpatient Hypoglycemic Rate Reduction Through the Implementation of Prescriber Targeted Decision Support Tools

Hypoglycemia has been shown to increase mortality and length of hospital stay and is now reportable to the Centers for Medicare and Medicaid Services as a quality measure. The purpose of this article is to review clinical decision support (CDS) tools designed to reduce inpatient hypoglycemic events.

CDS tools such as order set development, medication alerts, and data visibility have all been shown to be valuable tools in improving glycemic performance. This is especially true for hyperglycemic events with mixed results in hypoglycemia prevention. CDS solutions may be targeted directly to healthcare professionals or to specialty diabetes management teams to reduce hypoglycemia. Not all organizations have the financial resources to develop a diabetes management team so non-interruptive alerts may serve as an important tool to alert health care professionals of individuals with additional risk factors for the development of hypoglycemia. CDS can provide a mechanism to reduce the risk of hypoglycemia in hospitalized individuals. Although new research is promising, more studies are needed to determine future directions including the impact and feasibility of continuous glucose monitoring and predictive models to improve overall glycemic performance.