Process improvements and teamwork reduce hypoglycemic events

In 2019, Northwestern Medicine Lake Forest Hospital saw that they had an opportunity to improve the timeliness of repeat point-of-care (POC) blood glucose (BG) testing for patients following hypoglycemic events. Their quality improvement (QI) team joined the Vizient Performance Improvement Collaborative to network and help improve their health system’s performance with other leading health systems, setting a goal to increase the frequency of recheck timeliness from 33% to 75% by applying lessons from the collaborative.

Improvements in repeat blood glucose retesting

Northwestern Medicine LFG

Implementing a proven quality improvement methodology

Northwestern’s QI team implemented a quality improvement methodology, known as DMAIC (define, measure, analyze, improve, control) to drive process improvement which tracked glucometric data in their system’s enterprise data warehouse.

Timekeeping was identified as a key vulnerability, so nurses used timers and education to reinforce rechecking processes. After six months, the staff voted to create a worklist within their electronic medical record and automate aspects of their intervention via their electronic medical record system.

Starting in January 2020, the improvement for the pilot unit was dramatic. The percentage of repeat POC BG testing performed within 15-30 minutes after a hypoglycemic event increased to 70% in 2020 and has been sustained throughout 2021.

An approach for targeted quality improvement projects

Start with data

Leverage analytics resources to develop glucometrics for deeper insights

Involve staff to gather feedback and ideas

Partner with nursing leadership and staff early in the process to get the “voice of the customer”

Apply proven QI methodology

Use established tools along with education and methodology to systematically approach quality improvement

Hardwire changes to facilitate sustainability and spread

Automate processes through electronic medical record platforms after achieving success manually

"The process opened everyone’s eyes that we had opportunities for improvement. The fact that the changes weren’t done in a vacuum — and involved staff — helped us to change practices quickly and immediately improve patient care."

Simona Balu, MD
Northwestern Medicine Lake Forest Hospital

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