All of us at West Tennessee Healthcare work daily to support our mission of improving the health and well-being of the communities we serve. When we realized that 35 percent of our inpatient population was living with diabetes – a number well above the national average of 9 percent – we knew that a solution involving our entire staff was necessary.
With the leadership of our Chief Medical Officer and Chief Quality Officer, we built a Quality Improvement Team from members across the spectrum of care: physicians, nursing, pharmacy, labs, analysts, disease management, and more. Our team developed a plan for gathering data, identifying issues, standardizing treatment, and educating all hospital staff on a glycemic control program that would improve patient safety in the hospital, improve quality of care for diabetic patients in the community, and reduce costs and avoid readmissions for diabetic and hyperglycemic patients.
We partnered with the Society of Hospital Medicine to develop and implement this program, which required collecting EHR-maintained data such as A1C, blood glucose, C-peptide and body mass index as well as patient accounting data and other sources of information. Using McKesson Performance Analytics™, we were able to combine this data to create clinical dashboards and disease management scorecards that allowed us to go beyond looking at outcomes to find patterns, trends and root causes. We also share this data with 11 other hospitals through the Society of Hospital Medicine's Glycemic Control and Inpatient Care Coordination program, which allows us to benchmark our results.
A focus on analytics has enabled us to address both community-wide concerns and individual patient issues. We've identified opportunities to minimize drug-induced hypoglycemia with the pharmacy team. Analysis of the relationship between medication times and meal times guided our adoption of a new protocol for meal delivery and glucose readings. In the 17-county area we serve, we now know the level of HbA1c control in each county, so that we can design targeted patient education programs for different communities.
We're also able to identify those patients who would most benefit from disease management support, with patients who have an A1C level of 8 percent or greater and a blood sugar level greater than 300 triggering an automatic consultation. All patients receive a call from our outpatient case manager, who helps patients with discharge instructions, reconciling medications, filling prescriptions, and accessing further education and assistance.
Analytics has also helped track our results in real time so we can confirm that these interventions have had the desired impact. In a 14-month period, West Tennessee Healthcare has seen
- A 29 percent decrease in uncontrolled glycemic rates
- A 13 percent increase in normal glycemic rates
- A 29 percent decrease in the 30-day diabetic readmission rate
We're focused now on continuing to find new ways to reach out to our community, including targeted health fairs and continued education for those patients with the highest A1C levels. We're striving to reduce hypoglycemia rates while we maintain thresholds to meet our goals. The high value of "big data" in accomplishing our recent gains has also spurred our plans to implement McKesson Analytics Explorer™ to enhance data visualization and uncover additional insights.
To find out more about how West Tennessee Healthcare used McKesson Performance Analytics™ to drive data-supported initiatives that improved clinical care for individual patients, listen to the webinar Bringing Analytics to the Clinical Frontline, recorded on November 16, 2015.