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Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma

Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a per...

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Autores principales: Martinez, Elizabeth A., Chavez-Valdez, Raul, Holt, Natalie F., Grogan, Kelly L., Khalifeh, Katherine W., Slater, Tammy, Winner, Laura E., Moyer, Jennifer, Lehmann, Christoph U.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170784/
https://www.ncbi.nlm.nih.gov/pubmed/22091218
http://dx.doi.org/10.1155/2011/565069
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author Martinez, Elizabeth A.
Chavez-Valdez, Raul
Holt, Natalie F.
Grogan, Kelly L.
Khalifeh, Katherine W.
Slater, Tammy
Winner, Laura E.
Moyer, Jennifer
Lehmann, Christoph U.
author_facet Martinez, Elizabeth A.
Chavez-Valdez, Raul
Holt, Natalie F.
Grogan, Kelly L.
Khalifeh, Katherine W.
Slater, Tammy
Winner, Laura E.
Moyer, Jennifer
Lehmann, Christoph U.
author_sort Martinez, Elizabeth A.
collection PubMed
description Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.
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spelling pubmed-31707842011-11-16 Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma Martinez, Elizabeth A. Chavez-Valdez, Raul Holt, Natalie F. Grogan, Kelly L. Khalifeh, Katherine W. Slater, Tammy Winner, Laura E. Moyer, Jennifer Lehmann, Christoph U. Anesthesiol Res Pract Clinical Study Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period. Hindawi Publishing Corporation 2011 2011-09-06 /pmc/articles/PMC3170784/ /pubmed/22091218 http://dx.doi.org/10.1155/2011/565069 Text en Copyright © 2011 Elizabeth A. Martinez et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Martinez, Elizabeth A.
Chavez-Valdez, Raul
Holt, Natalie F.
Grogan, Kelly L.
Khalifeh, Katherine W.
Slater, Tammy
Winner, Laura E.
Moyer, Jennifer
Lehmann, Christoph U.
Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma
title Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma
title_full Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma
title_fullStr Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma
title_full_unstemmed Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma
title_short Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma
title_sort successful implementation of a perioperative glycemic control protocol in cardiac surgery: barrier analysis and intervention using lean six sigma
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170784/
https://www.ncbi.nlm.nih.gov/pubmed/22091218
http://dx.doi.org/10.1155/2011/565069
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