SC Acute Inpatient Glycemic Management’s (IGMP) Needs Assessment Sponsors:  Diabetes Initiative of South Carolina (DSC)  South Carolina Organization of Nurse Leaders (SCONL)  South Carolina Association for Healthcare Quality  South Carolina Hospital Association‘s "Every Patient Counts" Initiative

American Heart Association BlueCross BlueShield of South Carolina The Carolinas Center for Hospice and End of Life Care The Carolinas Center for Medical Excellence Diabetes Initiative of SC LifePoint, Inc. Mothers Against Medical Errors Palmetto APIC Palmetto Healthcare Liability Insurance Program Qualis Health SC Area Health Education Consortium SC Association for Healthcare Quality SC Chapter of the American Society for Healthcare Risk Management SC Node Supporting Partners SC Healthcare Association SC Joint Underwriting Association SC Medical Association SC Nurses Association SC Office of Rural Health SC Organization of Nurse Leaders SC Patients’ Compensation Fund SC Pharmacy Association SC Primary Health Care Association SC Society of Health-System Pharmacists SC State Budget & Control Board Office of Research & Statistics SC State Budget & Control Board Insurance Reserve Fund SCHA-SCMA Senior Medical Leadership Council 2

SURVEY SUMMARY (DECEMBER 2008) 3

Respondents  63 hospitals sent invitation  33 hospitals opened survey  32 hospitals completed survey Response Rate = 50.8% 4

Current Status in implementing an inpatient glycemic management program (IGMP) 5 N=33 hospitals answered this question

Current Status in implementing an inpatient glycemic management program (IGMP) by large/urban and small/rural hospitals 6 N=33 hospitals answered this question

IGMP Elements in Place N=25 hospitals answered this question 7

Policies in Place? Hospital-wide glycemic management ICU glycemic management N=32 N=31 8

By Large/Urban and Small/Rural % Hospital-wide glycemic management % ICU glycemic management 9

Glycemic Management program Formed a team Barriers that need addressing N=32 N=31 10

Hospital formed a Glycemic Management Program by Small/Rural and Urban/Large Hospitals 11 N=32 hospitals answered this question

Correction insulin (sliding scale) used by itself N=33 hospitals answered this question 12

If used in your facility, what area is it found? 13

All areas where insulin IV infusion protocols may be used N=32 hospitals answered this question 14

All areas where diabetes order sets for SubQ basal-bolus administration may be used N=32 hospitals answered this question 15

All areas where hypoglycemia policy/protocol may be used N=32 hospitals answered this question 16

All areas where an insulin pump patient/protocol may be used N=29 hospitals answered this question 17

Facility use a proprietary vendor program for IV infusion protocols N=33 hospitals answered this question 18

Facility use a proprietary vendor program for IV infusion protocols by Small/Rural and Urban/Large Hospitals 19 N=33 hospitals answered this question

Type of proprietary vendor program for IV infusion protocols that Hospitals are using Proprietary Vendor Program Endotool Glucomander Alaris MDN-CGS 20

Insulins Devices currently used All insulins on your fomulary N=26 N=32 21

OUTCOME MEASURES 22

Outcome Measures to determine impact of your program 23

Useful “tools” for your IGMP N=32 hospitals answered this question 24

Interested Participating in a IGMP Collaborative N=30 N=29 Sharing de-identified data in IGMP Collaborative 25

Top Priorities  Standardized protocols/policies/order sets  Education initiatives  Outcomes/Metrics 26

Recommendations  DSC (and partners) Add sessions on inpatient glycemic management (such as best practices and policies) to DSC Educational Programs Support development & implementation of a public domain calculator  SCHA Develop protocol/policy samples using experts Design & develop content for education using experts Provide “train the trainer” program to use developed content at local sites Develop/maintain web-site with tools 27

SURVEY QUESTIONS 28

Questions 29 Please describe your current status in implementing a formal or structured inpatient glycemic management program. Please indicate if the following elements are in place with your program. Do you have hospital-wide glycemic management polices in place? Do you have ICU glycemic management policies/protocols in place? Please check all areas in your hospital where insulin IV infusion protocols may be used: Please check all areas in your hospital where diabetes order sets for SubQ basal-bolus administration may be used: Is correction insulin (sliding scale) being used by itself? If a hypoglycemia policy/protocol is used in your facility, please check all areas where it may be found: If an insulin pump patient policy/protocol is used in your facility, please check all areas it may be used: Please describe the involvement, if any, of patients in your insulin pump patient policy/protocol.

Questions 30 Has your hospital formed a Glycemic Management Team? Please identify the barriers your facility needs to address in order to advance a glycemic management program: (check all that apply) What outcome measures do you use, or plan to use, to determine the impact of your program? Does your facility use a proprietary vendor program for IV infusion protocols? Please check all insulins that are on your formulary: Which devices are currently being used? What "tools" would be useful as you move forward with your glycemic management program? Is your hospital interested in participating in an Inpatient Glycemic Management Collaborative sponsored by SCHA, DSC, SCONL, and SC AHQ? Is your organization willing to share de-identified data with the other hospitals in an Inpatient Glycemic Management Collaborative? In your opinion, what should be the three top priorities of an Inpatient Glycemic Management Collaborative in our state? Please enter your demographic information below.