Improving Blood Sugar Control in Heart Surgery Patients
Author Information
Author(s): Elizabeth A. Martinez, Raul Chavez-Valdez, Natalie F. Holt, Kelly L. Grogan, Katherine W. Khalifeh, Tammy Slater, Laura E. Winner, Jennifer Moyer, Christoph U. Lehmann
Primary Institution: Johns Hopkins Medicine
Hypothesis
The comprehensive Lean Six Sigma approach would generate a substantial and sustainable improvement in perioperative glucose control.
Conclusion
The implementation of a glycemic control protocol significantly improved the percentage of cardiac surgical patients with controlled blood sugar levels.
Supporting Evidence
- Before the protocol, only 33% of patients had an admission glucose <200 mg/dL.
- After implementation, 94% of patients had an admission glucose <200 mg/dL.
- The average number of glucose measurements per patient per day increased from 3 to 12.
- The time to achieve glucose control decreased from a median of 16 hours to 9 hours.
Takeaway
This study shows that by using a special method called Lean Six Sigma, doctors can help heart surgery patients keep their blood sugar levels in a healthy range.
Methodology
The study used Lean Six Sigma methods to implement a glycemic control protocol in a cardiac surgical ICU, involving pre- and post-intervention audits and data collection.
Potential Biases
Potential bias due to the lack of comparison with other quality improvement methodologies.
Limitations
The study did not collect demographic data on patients, which could have provided insights into predictors of hypoglycemia.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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