ODP253 Utilizing EMR Optimization to Streamline Inpatient Blood Glucose Management and Improve Clinician Efficiency

Abstract

Abstract Introduction Diabetes mellitus is a common disease that is prevalent in over 30.3 million people in the US. The annual cost of diabetes related inpatient care is over $97 billion. Poor glycemic control has been associated with increase hospital length of stay, increased cost and increased mortality. One of the challenges faced by clinicians in managing inpatient blood glucose is the lack of easy access to necessary data. The various pieces of information needed for comprehensive inpatient blood glucose management were in different parts of the EMR and required multiple clicks to access. The glucose flowsheet 2. 0 was created to remedy this problem. The flowsheet aggregated data necessary onto one screen and displayed it in a context specific manner. The flowsheet aimed to decrease the amount of time spent and the number of clicks needed to gather data clinicians need to manage blood glucose in inpatients. Method/Quality Improvement action: Glucose flowsheet 2. 0 aggregates the following information. Blood Glucose, Fingerstick Glucose, A1c, Dextrose infusions, Steroid (name/dosing), Tube feeds (name/rate), Nutritional Supplement (name//frequency), Percentage of Meal eaten, Vasopressors and Creatinine/GFR. After the flowsheet went live inpatient providers and nursing staff were sent an email educating them about the changes to diabetes flowsheet and how to access it. Six Months after the diabetes flowsheet went live a 6-question survey was sent to approximately 300 residents and advanced practitioners taking care of inpatients and received 69 responses. Results The survey had a response rate >20% with a confidence interval of 90% and less than 10% margin of error between the survey responders and the population of clinicians involved in adult inpatient management. 90.7% of survey respondents agreed/strongly agreed "flowsheet 2. 0 gives me relevant and up to date information needed manage blood glucose for hospitalized patients." 87.7% of respondents agreed/strongly agreed that "allows me to view more relevant diabetes and blood glucose related data than on one screen compared to glucose flowsheet 1. 0." 80% and 85% of participants agreed/strongly agreed that the flowsheet 2. 0 improved efficiency by reducing time needed and clicks required to gather necessary data for inpatient blood glucose management. 80.6% of respondents agreed/strongly agreed that "Glucose Flowsheet 2. 0 helps me to save time without compromising quality of diabetes care." 80.6% of respondents agreed/strongly agreed that "the changes implemented in the Glucose flowsheet 2. 0 makes it more likely for me to minimize, prevent, identify or correct errors". Clinicians found the optimization of EMR to be a net positive that saves time without compromising quality of care. This quality improvement project shows that data presented in EMR can be optimized in a context specific manner to improve clinicians’ sense of efficiency. Presentation: No date and time listed