Quality improvement process: This group will focus on formulating a how-to resource for performing quality improvement projects related to glycemic control. This group will attempt to provide hospitalists with a practical guideline to help them successfully implement changes in their own institutions. Topics will include forming and leading a multidisciplinary team, setting goals, defining metrics, and identifying process analysis and evaluation methods.
Deliverables from this group will likely include a glycemic control quality improvement workbook that will guide individuals through the complex process of performing robust quality improvement projects in their own hospitals. This workbook will be similar in format to one that is currently available in the “VTE Quality Improvement Resource Room” on the SHM Web site.
Clinical tools: This group will focus on compiling and appraising already existing clinical tools (e.g., standardized order sets, protocols) and identifying the key features of these tools and the differences among them. The emphasis will be on either compiling or creating ready-to-use clinical tools.
Potential deliverables from this group include a collection of tools that will have substantial built-in decision support and will be useful in a range of settings. These might include standardized order sets, protocols, and charting tools.
Metrics: This group will focus on defining useful metrics for performing glycemic control research and quality improvement projects. This group intends to define the best ways to measure glycemic control, balancing measures, process measures, and other specific outcomes. These metrics will allow hospitals to examine their current performance and to develop quality standards for inpatient glycemic control.
Care transitions: This group is charged with beginning to identify and address the many challenges that are faced when diabetic and/or hyperglycemic patients move from one care setting to another (e.g., ICU to general ward, hospital to outpatient setting). The work done by this group is likely to have an impact on all of the other groups.
Potential deliverables from this group include a set of standards that can be applied to care transitions. There may also be specific clinical tools developed to improve the process of these care transitions, such as checklists, order sets, and protocols.
Promotional: This group will focus on creating national awareness of the importance of glycemic control in hospitals, particularly at the administrative level. This may include efforts to partner with relevant medical societies, regulatory agencies, and other professional organizations focused on improving glycemic control.
Goals and Timelines
The three-month goal is for each of the focus groups is to further delineate the gaps in the existing resources, and to further refine the specific deliverables that they will produce. Each group will need to determine specific goals and timelines.
An intermediate-term goal is the formation of a white paper that will describe, in detail, the existing glycemic control resources, the gaps in these resources, and the need for additional work in these areas.
In addition, work on the glycemic control quality improvement workbook is under way, and this resource will be used in the “Quality Improvement Precourse” that will take place May 3, 2006, at the SHM Annual Meeting.
The work being done by this task force will lead to a collection of high-quality, user-friendly resources that will enhance awareness of the issue of inpatient glycemic control and facilitate the implementation of effective inpatient diabetes quality improvement across the nation. The longer term goal will be to bring about demonstration projects in the area of inpatient glycemic control and advance the science of diabetes care in the hospital.