378-P: Real-Time Inpatient Hypoglycemia Intervention Reduces the Rate of Recurrent Severe Hypoglycemia

Abstract

Hypoglycemic events are a common inpatient safety issue; over half are preventable. There are no studies of real-time detection/response to prevent recurrence of hypoglycemia. We evaluated the effectiveness of real-time electronic hypoglycemia surveillance program (REHSP) to reduce the rate of recurrent severe hypoglycemic events (RHE) in hospitalized patients. REHSP is driven by a multidisciplinary team of endocrinologists and nurse practitioners who review an electronic database of all inpatient hypoglycemia events in the last 24hrs. Recommendations to reduce RHE are given to primary teams and appropriate response is monitored. We compared recurrence rates of severe hypoglycemia (BG <50 mg/dL) in inpatients with at least one severe hypoglycemic event (index event) 1 year Pre-REHSP vs. 1 year Post-REHSP implementation. RHE were defined as severe hypoglycemia occurring 20 hours and more after the index event (based on CMS criteria). The primary outcomes were rates of RHE and appropriate response by the primary teams. The Table shows that demographic and clinical characteristics were similar in both groups. In the Post-REHSP group the rates of RHE and length of stay declined significantly and the appropriate response of the teams significantly increased. This study highlights the potential of reducing recurrent hypoglycemia through real-time intervention. Disclosure Y. Gorantla: None. S.T. Yap: None. Y. Guerra: None. L. Fogelfeld: Research Support; Self; Bayer Healthcare Pharmaceuticals Inc., Gan & Lee Pharmaceuticals, Gilead Sciences, Inc., Merck & Co., Inc., Sanofi.