Sentara Health System Prepares for VBP Measure Changes With SCIP Inf-4 by Turning to Patient Centric IV Insulin Dosing Software

Sentara Health System Prepares for VBP Measure Changes With SCIP Inf-4 by Turning to Patient Centric IV Insulin Dosing Software

Presentation

American Diabetes Association Scientific Sessions

Date

June 2014

Authors

Raymie McFarland, Paul Chidester, Joseph Aloi, Stephanie Conner, Susan Schriever

Abstract

Hyperglycemic control has long been associated with improved in-hospital mortality and morbidity in the cardiac surgical population. Successful experience with Glucommander, a web based insulin algorithm integrated with the hospital EHR, in inpatient insulin protocols suggested that its expanded use across the Sentara Health System would provide both safe and improved outcomes for SCIP Inf-4 (Defined as blood glucose less than 200 md/dl post op day 1 and day 2). We plan to study the effectiveness of the Glucommander (GM) system for the treatment of hyperglycemia in the post cardiac surgical patient population.

This 12 month quality initiative is being conducted at Sentara Healthcare System in southeast Virginia with the Sentara Heart Hospital (HH) at 157 Inpatient and Pre/Post rooms undergoing interventional cardiac procedures serving as our study site. All post surgical cardiac patients are placed on GM for their glycemic management.

In 2012 the HH had a baseline result of 26 fallouts for a score of 95.1%. January 1 - June 16, 2013 the HH had 10 fallouts for a score of 95.9% before GM. June 17 - November 30, 2013 GM achieved 2 fallouts for a score of 99.2%. Both Glucommander fallouts were the result of the System being discontinued to soon or not being initiated within the measurement window. Glucommander achieved a SCIP Inf-4 score of 100% when utilized during the entire measurement window for post cardiac patients. Patient safety also improved as hypoglycemia <70 mg/dl was reduced by 52% from 1.63% to 0.78% when Glucommander was used.

  • Use of the patient specific insulin infusion algorithm GM to treat post surgical cardiac patients improved HH into the top 10% performers for the Value Based Purchasing (VBP) Measure SCIP Inf-4 from a score of 95% to 99%+ in under 6 months with a decrease in hypoglycemia. Our results suggest that Glucommander is a safe and efficient tool for improving patient care and increasing the hospital’s performance on the VBP SCIP Inf-4 measure.
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