A Unified System-Wide Electronic Dashboard for Inpatient Glucose Management Across a Large Health System

Area of Science:

• Healthcare Quality Improvement
• Clinical Informatics
• Diabetes Management

Background:

• Inpatient glycemic control remains a significant challenge despite established guidelines and quality metrics.
• A system-wide glucose monitoring dashboard can aid in consolidating and visualizing key metrics for quality improvement (QI).

Purpose of the Study:

• To evaluate the impact of a system-wide electronic dashboard on inpatient glycemic control and key quality metrics.
• To assess the dashboard's effectiveness in standardizing care and supporting QI across diverse hospital settings.

Main Methods:

• A web-based diabetes dashboard was implemented across 7 hospitals, monitoring monthly electronic health record data.
• Key metrics analyzed included hypoglycemia, hyperglycemia, mortality, length of stay (LOS), and 30-day readmissions (ED/IP/OBS) for 455,303 admissions (2018-2025).
• Statistical analyses included t-tests, Wilcoxon rank-sum tests, and difference-in-differences analysis to compare pre- and post-implementation periods and hospital types.

Main Results:

• Dashboard implementation was associated with decreased patient-days with hypoglycemia (4.81% to 4.15%) and hyperglycemia (25.30% to 23.46%).
• Significant reductions were observed in in-hospital mortality (2.69% to 2.13%) and length of stay (7.56 to 7.29 days).
• Emergency department and inpatient/observation readmissions showed slight increases, with variations observed between academic and community hospitals.

Conclusions:

• A system-wide electronic dashboard is associated with improved glycemic control, reduced mortality, and shorter length of stay.
• These dashboards effectively support multidisciplinary collaboration and quality improvement initiatives in various hospital environments.