Glycemic Control Collaborative

1. Glycemic Control Collaborative PowerHour Information 03/09/2011

2. Outline • Background • Description • Vision • Mission • Measurements • Participation Requirements

3. Background • There will be a 230% increase in diabetes cases in our state over the next twenty years.1 • Diabetes costs per year are $5 billion and are expected to increase to almost $12 billion per year. • Currently, new cases of blindness occur at 1000 per year, there are also 1,700 new cases of renal failure and 3,400 lower limb amputations in Georgia alone. These devastating complications are expected to more than double by 2025.  • Recent studies have shown great improvement in hospitalized patient’s outcomes when blood glucose is closely monitored and managed. 2,3

4. Background • Preventing and controlling diabetes and the complications of diabetes are crucial and greatly impacts patient safety. • Standardization of practice will enhance the practitioner’s ability to provide quality care to patients in Georgia. • Using Best Practices will help increase Glycemic Control for patients.

5. Description • A free tool available from GHA for hospitals to use for data collection • It is easy to install, transmit data, and run reports for your hospital • Aggregate data will be sent to PHA for analysis for your hospital and across the state • Hospitals can use other resources that help them collect the same data required for the collaboration

6. Vision • To minimize the frequency of severe hypoglycemic events in Georgia Hospitals • To minimize the frequency of hyperglycemia in Georgia hospitals • To maximize the number of patients achieving euglycemia during hospitalization in Georgia Hospitals • To minimize the frequency of 30-day readmissions due to hyperglycemia

7. Mission • To improve the overall health outcomes of hospitalized patients with diabetes in the state of Georgia by • tracking outcomes data for the purpose of identifying opportunities for improvement • and demonstrating progress through education and the implementation of evidence-based treatment guidelines that assist hospital staff with the care and treatment of patients with diabetes

8. Measurements(Numerators , Denominators and definitions to be provided upon sign up) • Percent of blood glucose measurement less than 40 mg/dL • Percent of patients whose last blood glucose measurement was greater than 300 mg/dL • Percent of patients with an average mean glucose during hospitalization between 140 mg/DL and 180mg/dL • Number of patients readmitted within 30 days of initial discharge where hyperglycemia is either the primary or secondary discharge

9. Participation Requirements • Submit CEO Commitment Letter and Memorandum of Agreement • Participate in monthly education calls • Submit self–assessment/Action Improvement Plan • Submit quarterly data

10. Questions?

11. Resources • 1Lowley, William, “The Looming Diabetes Crisis in Georgia: What it is now and what it will become by 2025” CDC publication, May, 2006. • 2 Van den Berghe G , Wouters P , Weekers F, et al. “Intensive insulin therapy in the critically ill patients” N Engl J Med . 2001;345(19):1359–67. • 3Krinsley, James S, Association Between Hyperglycemia and Increased Hospital Mortality in a Heterogeneous Population of Critically Ill Patients, From the Division of Critical Care, The Stamford Hospital, Stamford, Conn