title: An institutional process to improve inpatient glycemic control.
abstract: Many institutions are evaluating their inpatient patterns of care for patients with diabetes mellitus and hyperglycemia, based upon compelling evidence that strict glycemic control improves outcomes in a variety of hospital settings. In 2005, a multidisciplinary task force was established at the University of Kentucky Chandler Medical Center in Lexington, Kentucky, to guide a process to improve the quality and safety of inpatients with hyperglycemia. This article describes the stepwise process including an examination of our procedures, adoption of standards, and establishment of common protocols and procedures. Successful implementation of the protocols was preceded by extensive educational efforts. Refinement of the protocols based on early experience and feedback from staff has resulted in improvements in glycemic parameters and less reliance on sliding scale insulin regimens.
authors.affiliation: University of Kentucky Chandler Medical Center, Department of Medicine, Division of Endocrinology, Lexington, KY 40536, USA. Lrreyn2@uky.edu
authors.forename: L Raymond
authors.initials: LR
authors.lastname: Reynolds
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Cook
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Lewis
authors.forename: M Claire
authors.initials: MC
authors.lastname: Colliver
authors.forename: Sheri S
authors.initials: SS
authors.lastname: Legg
authors.forename: Nina G
authors.initials: NG
authors.lastname: Barnes
authors.forename: Joseph
authors.initials: J
authors.lastname: Conigliaro
authors.forename: Richard P
authors.initials: RP
authors.lastname: Lofgren
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D002985:Clinical Protocols; D006745:Hospital Bed Capacity, 300 to 499; D006785:Hospitals, University; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D013192:Staff Development / Q000458:organization & administration; D014193:Trauma Centers
chemical_list: D001786:Blood Glucose