SHM Glycemic Control Task Force Summary

Practical Recommendations for Assessing Inpatient Glycemic Control Efforts

Greg Maynard, Maynard, Michelle Magee, and Jeff Schnipper

The Society of Hospital Medicine, together with representatives from the American Diabetes Association, AACE, ACP, and others, is working to develop standardized measures of inpatient glucose control and related indicators to track progress of hospital glycemic control initiatives. The goals of these recommendations (listed in the table below) are severalfold:

1. Create a set of measurements that are complete but not overly burdensome
2. Create realistic measures that can be applied to institutions with different data management capabilities
3. Allow for comparison across institutions for benchmarking purposes, evaluation of quality improvement projects and reporting of results for formal research studies in this field

For each domain of glycemic management (glycemic control, safety, and insulin use), the task force chose a set of “best measures.” They are presented as two tiers of measurement standards, depending on the capabilities of the institution and the planned uses of the data. Tier 1 includes measures that, although they do take time and resources to collect, are feasible for most institutions. Tier 2 measures are recommended for hospitals with easy manipulation of electronic sources of data and for reporting quality-of-care measures for widespread publication, that is, in the context of a research study. It should be emphasized that these recommendations are only meant as a guide: the actual measures chosen should meet the needs and capabilities of each institution.

Tier 1 measures are in black, and tier 2 measures are in blue.

We recognize that few data support the recommendations made by this task force, that such data are needed, and that the field of data collection and analysis for hospital glycemic management is rapidly evolving. These measures are put forward as an attempt to begin the process of standardizing glycemic measures in the inpatient setting. Because many of these measures are somewhat arbitrary, the SHM and the authors of this resource room and the implementation guide call for a more formal recommendation for glucometrics to be developed in collaboration with the ADA, AACE, and other pertinent stakeholders.

View the SHM Glycemic Control Task Force Summary