Thérèse Franco1, Barry Aaronson2, Barbara Williams3, Craig Blackmore4. 1. Section of Hospital Medicine, Virginia Mason Medical Center, 925 Seneca, H8-25, Seattle, WA 98101, USA. Electronic address: therese.franco@vmmc.org. 2. Section of Hospital Medicine, Virginia Mason Medical Center, 925 Seneca, H8-25, Seattle, WA 98101, USA. Electronic address: barry.aaronson@vmmc.org. 3. Center for Healthcare Improvement Science, Virginia Mason Medical Center, 1000 Seneca, Blackford Hall, Room 322-3, Seattle, WA 98101, USA. Electronic address: barbara.williams@vmmc.org. 4. Center for Healthcare Improvement Science, Virginia Mason Medical Center, 1000 Seneca, Blackford Hall, Room 322-3, Seattle, WA 98101, USA. Electronic address: craig.blackmore@vmmc.org.
Abstract
AIM: The clinical andon board (CAB) is a novel electronic surveillance and communication system, which alerts providers to and prompts treatment of dysglycemia. This investigation was designed to determine the CAB's effectiveness in supporting adherence to standardized evidence-based protocols, as well as improving glycemic control. METHODS: This study was a retrospective pre/post analysis of insulin orders and blood glucose values. We used a Student's t-test for continuous variables and Chi2 for all other variables. This study included patients 18 years or older admitted to the hospital medical service as an inpatient with a length of stay greater than 24 h and less than 90 days. We used Pearson's correlation coefficient to evaluate the relationship between CAB and blood glucose. RESULTS: The rate of compliance in prescribing basal insulin for patient with diabetes increased from 56% to 77% (p < 0.001). Similarly, compliance rates for prescribing correctional insulin in patients without diabetes increased from 15% to 37% (p < 0.001). Performance on the CAB was linearly related to blood glucose (p = 0.004), and there was a small statistically (not clinically) significant improvement in mean blood glucose values. CONCLUSION: This approach is effective in alerting and engaging providers to prescribe insulin in a standardized manner with potential to improve glycemic control.
AIM: The clinical andon board (CAB) is a novel electronic surveillance and communication system, which alerts providers to and prompts treatment of dysglycemia. This investigation was designed to determine the CAB's effectiveness in supporting adherence to standardized evidence-based protocols, as well as improving glycemic control. METHODS: This study was a retrospective pre/post analysis of insulin orders and blood glucose values. We used a Student's t-test for continuous variables and Chi2 for all other variables. This study included patients 18 years or older admitted to the hospital medical service as an inpatient with a length of stay greater than 24 h and less than 90 days. We used Pearson's correlation coefficient to evaluate the relationship between CAB and blood glucose. RESULTS: The rate of compliance in prescribing basal insulin for patient with diabetes increased from 56% to 77% (p < 0.001). Similarly, compliance rates for prescribing correctional insulin in patients without diabetes increased from 15% to 37% (p < 0.001). Performance on the CAB was linearly related to blood glucose (p = 0.004), and there was a small statistically (not clinically) significant improvement in mean blood glucose values. CONCLUSION: This approach is effective in alerting and engaging providers to prescribe insulin in a standardized manner with potential to improve glycemic control.