Improving Glycemic Control on GMS: A Quality Improvement Study

Study Overview
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Brief Summary
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This study will examine whether new processes and technologies for monitoring diabetic patients' insulin levels improves patient care at Brigham and Women's Hospital.

Detailed Description
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This study will examine whether new processed and technologies for monitoring diabetic patients' insulin levels improves patient care. Patients at Brigham and Women's Hospital (BWH), staying on the General Medicine Service, who have Type 2 diabetes and who are not on IV insulin can participate in this study. Physicians and nurses will be taught new rules to care for diabetic patients, while in the hospital. Also, the BWH computer system will be updated to include these new rules for administering insulin. Patients who participate in the study will be randomly placed into one of two groups: one group that will be cared for by physicians and nurses who have learned these new rules for administering insulin; or the second group, who will receive diabetes care at BWH before the new rules were adopted. The study will last approximately 1 year.

Official Title
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Improving Glycemic Control on GMS: A Quality Improvement Study

Conditions
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Diabetes Mellitus

Intervention / Treatment
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* Behavioral: Order Set, Education, Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects will include all type 2 diabetic patients on the General Medicine Service (GMS) of Brigham and Women's Hospital (BWH) who do not have an indication for IV insulin. Exclusion Criteria: Type 2 diabetic patients on the General Medicine Service (GMS) of Brigham and Women's Hospital (BWH) who have an indication for IV insulin.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual Care<br>admission to medical team floor to usual care | |
| Experimental: Intervention<br>consists of usual care as well as an admission order set built into BWH's proprietary computer provider order entry (CPOE) system | Behavioral: Order Set, Education, Feedback<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| - Point-of-care testing glucose values (percent of routine glucose readings between 60 and 180 mg/dL) |  |  | 
| - Lab glucose values (percent of routine glucose readings between 60 and 180 mg/dL) |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| - Quality of insulin orders using explicit criteria |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diabetes Mellitus, Outcome Assessment (Healthcare), Inpatients, Hospital Information Systems, Education