Evolution of a diabetes inpatient safety committee.
OBJECTIVE
To develop a multidisciplinary team, the Diabetes Inpatient Safety Committee (DPSC), to effectively address the many barriers to achieving glycemic control in the inpatient setting.


METHODS
The development, implementation, and successes of the DPSC are described.


RESULTS
By focusing on prevention of severe hypoglycemia, the DPSC identified and addressed areas related to inpatient management that contributed to uncontrolled glucose levels. The introduction of a hypoglycemia treatment protocol was followed by the development of a standardized order set for use of sliding scale insulin, with the eventual introduction of an Insulin Order Set guiding the use of scheduled and correctional insulin. Protocols and guidelines addressing more specific areas of inpatient glycemic management (insulin pump therapy, perioperative management, diabetic ketoacidosis, intravenous insulin) also have been developed.


CONCLUSIONS
The successes of the DPSC to date have been directly related to strong institutional support, the dedication of a multidisciplinary team to address specific areas of glycemic management, the programmed introduction of order sets in conjunction with structured educational programs that accompany each protocol, and the use of quality improvement measures to evaluate the safety and efficacy of these protocols. Effective committees such as this will be instrumental in preventing errors and maximizing euglycemia.
Korytkowski
Mary
M
Divisions of Endocrinology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Dinardo
Monica
M
Donihi
Amy C
AC
Bigi
Lori
L
Devita
Michael
M
D003920:Diabetes Mellitus / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D007297:Inpatients; D019300:Medical Errors / Q000517:prevention & control; D016134:Organizational Policy; D005791:Patient Care / Q000379:methods; D010348:Patient Care Team / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D017751:Safety Management / Q000379:methods / Q000458:organization & administration