Diabetes Champions of Change: A Multi-disciplinary Team Approach to Improving Diabetes Care

Purpose:
Implement a “Diabetes Champion Team” to engage staff and achieve excellence in the delivery of acute care and transition of care to patients with diabetes or hyperglycemia as a component of the inpatient diabetes program, integrating the Chronic Care Model and Champions Model.

Significance:
Evidence shows that inpatient glycemic control in select populations improves outcomes. Approximately 25% of inpatients require glycemic management, so a multidisciplinary partnership was employed to ensure all staff have knowledge of best practices for this large inpatient population.

Strategy and Implementation:
The “Diabetes Champions Team” was spearheaded by UCH Diabetes Program staff and a bedside nurse. A group charter was developed. Registered Nurse representatives were enlisted from each inpatient unit. Also enlisted were representatives from pharmacy, lab, nutrition, the Glucose Management provider team, and the DM program medical director. Priorities for performance improvement projects were decided as a team, engaging the Magnet culture of shared leadership, and recognizing the need to expand evidence-based diabetes care to the purvue of the frontline staff. Priority projects that have been identified by the Diabetes Champion Team include safe transition of DM care into the new EMR system, DM Champ expertise on DM resources, improvement of hypoglycemia care, and trial of a process for patients discharged new to insulin. Each diabetes “Champ” is responsible to analyze their unit data, educate staff, analyze outcomes, and share data with unit staff and DM Champion Team.

Evaluation:
Seven DM Champ meetings have been held. Team was trained on DM aspects of new EMR, educated staff, and revised EMR to improve DM safety. Champs collected unit hypoglycemia data, educated staff, and 1 unit had twofold improvement in hypoglycemia care. Two units started an insulin discharge trial.

Implications for Practice:
Despite hospital implementation of evidence-based DM practices, individual units had knowledge deficits and inconsistent communications regarding DM care. The Champions are accessible, unit-based staff, knowledgeable about DM resources and they provide staff education and consistent communications