Making it Happen

Models of Implementation

In this section you will find:

• Slide Presentation
• Reference List and Key Readings
• Selected published literature

Key Points:

• Models for implementation of improved control of hyperglycemia include:  

  • Consultant Model
  • Diabetes Team Model
  • System-Wide Model
• It is important to adapt the model you choose to fit your particular institution’s needs
• This section describes these models, their advantages and disadvantages, and factors that are critical for successful implementation
• Critical success factors often include:
  
  • A committed champion of the effort (a major opportunity for the endocrinologist)
  • Administrative support – should be a major early goal
  • An engaged multidisciplinary steering committee
• The multidisciplinary steering committee should:
  

  • Include medical staff, administration, nursing, case management, pharmacy, nutrition, dietary, laboratory, quality improvement, and information systems
  • Assess current processes, quality of care, and barriers to practice change
  • Strive to achieve broad buy-in to facilitate successful implementation of initiatives 
• Successful implementation of a program to improve glycemic control in the inpatient setting should usually include the following components:
  

  • Policies 
  • Protocols and algorithms
  • Standardized order sets
  • Metrics for evaluation
  • Educational programs (including for physicians and nurses)

Finally:

Since hyperglycemia in the hospital is:
A quality of care issue,
A patient safety issue,
A length of stay issue, and
A cost issue,
Addressing hyperglycemia in hospitalized patients can unite professionals in a common quest.