PIONEER’S QUALITY CORNER FEATURING ANTHONY MIKAEL, MBA, CAO MULTIDISCIPLINARY GLYCEMIC COLLABORATION

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The Pioneer team is committed to providing quality service and identifying opportunities for Improvement. AdventHealth Ocala was performing under the benchmark in Quality Hyperglycemia, as well as Hypoglycemia in non-ICU and ICU settings. This outcome was the result of inefficient processes and communication needs. This included a lack of real-time awareness and an opportunity for ideal preventative management of inpatient glucose needs. Pioneer physicians, AHO nursing, as well as the Director of Hospital Medicine Erin Asselta’s team established an inpatient, non-critical care 5S pilot to guide ideal processes and communication standards for appropriate and early glycemic management.

These processes included:

  • A glycemic report fired to physicians and ANMs twice per day, one at 8:30AM and another at 1:30PM,
  • Highlighting potential fallouts100% MDR discussion Monday – Sunday
  • Daily tracking of percent of patients “carried over” from previous day on AM report

This resulted in increased awareness and cooperation amongst the team and sparked enthusiasm for achieving a shared goal.

This project lasted approximately four weeks and resulted in an improved Quality Hyperglycemia score from 79.8 to 93.5 points (March to April). In addition, the team was able to achieve their Hypoglycemia Non-ICU threshold three months in a row.

In collaboration with AHO administration, the Medical Director and Co-Director, Dr. Rao and Dr. R. Ahmad,
were able to revise the glycemic policy and have it more aligned with the quality metrics thresholds.

Next steps:

  • Continue to receive reports and incorporate all physicians.
  • Expand nurse education.
  • Incorporate pharmacy to help support the process.

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