Gordon West (Annenberg Center for Health Sciences at Eisenhower); Eric Peterson (Annenberg Center for Health Sciences at Eisenhower); Philip Dombrowski (Annenberg Center for Health Sciences at Eisenhower); Anna Moll (Annenberg Center for Health Sciences at Eisenhower)

Synopsis

Despite the safety benefits of basal/prandial/correctional insulin protocols over conventional slidingscale insulin protocols, sliding scale protocols persist in most hospitals. Because of the multiple stakeholders involved, making the transition to safer and more contemporary protocol is difficult and many hospitals postpone the task in the face of multiple competing priorities. This intervention recruited 10 hospitals from around the US to take part in an improvement project using and intraprofessional team learning model within a quality improvement framework.

Body

The Annenberg Center’s intervention has the following features:

1. Participation was by formal application signed by the chief medical officer naming the team and committing resources to the project
2. After selection, a visit to the institution by 1 physician and 1 nurse with experience implementing IIPs was conducted. The visiting experts met privately with the institutional team to discuss their current performance and proposed project. Where possible, the visiting experts also gave presentations in staff-wide forums such as Grand Rounds
3. The institutional champions and the interdisciplinary team participated in 3 Web conferences during which they had the opportunity to interact with faculty and with other participating institution to discuss problems and barriers they were facing and their strategies for overcoming these barriers. During the final Webcast, Institutional Champions will present their results to their peers.
4. Institutional Champions had access to a Web site containing sample protocols, tools, educational materials, and key literature. Institutional Champions had an opportunity to interact with each other and with faculty in a secure area of the Web site to discuss barriers, frustrations, and successes and share best practices. At the end of the intervention, performance change was assessed.
5. All sites were successful in implementing at least 1 process related to glycemic control and several implemented more than one. Projects and associated outcomes differed among sites.

Funding Sources

Funding for this activity was provided through an educational grant by Sanofi.