Delivery of Guideline Directed Care for Inpatient Glycemic Management: Quality Improvement Implementation

Area of Science:

• Internal Medicine
• Endocrinology
• Diabetes Management

Background:

• Effective glucose management is crucial for hospitalized patients, impacting wound healing and preventing hypoglycemia.
• Virtual Glucose Management Services (VGMS) offer remote expert oversight for inpatient glycemic control.
• Assessing VGMS effectiveness in a large academic medical center was the study's objective.

Purpose of the Study:

• To evaluate the effectiveness of a Virtual Glucose Management Service (VGMS) for improving glycemic management in hospitalized individuals.
• To compare glycemic outcomes between units utilizing VGMS and control units.

Main Methods:

• A prospective, quality improvement intervention-control study was conducted.
• Inclusion criteria: hospitalized individuals (≥18 years) with point-of-care blood glucose <70 mg/dL or >200 mg/dL.
• VGMS was implemented in four units, with outcomes compared to two control units over two years.

Main Results:

• The study included 1338 individuals in the intervention group and 1019 in the control group.
• Average glucose levels were similar between groups (175.9 mg/dL vs 174.1 mg/dL).
• The intervention group had a significantly lower proportion of hyperglycemia (POC BG >180 mg/dL) compared to the control group (65.5% vs 72.2%).

Conclusions:

• Implementation of a VGMS team significantly reduced hyperglycemia in hospitalized patients.
• VGMS is an effective and efficient strategy for improving inpatient glycemic management.
• This model demonstrates potential for widespread adoption in hospital settings.