Multidisciplinary Team Pioneers Inpatient Diabetes Management Strategy

Thursday, September 13, 2012

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On September 14, 2012, Baptist Medical Center received Mississippi’s first and only Advanced Certification in Disease-Specific Care for Inpatient Diabetes by Joint Commission.

In 2006, the American College of Endocrinology and the American Diabetes Association challenged health systems to tackle the problem of diabetes with inpatient populations. This call to action led the Pharmacy Department at Baptist Medical Center in Jackson, Miss. to implement the Multidisciplinary Diabetes Management Team. The team includes physicians, pharmacists, diabetes nurse educators and dietitians.

“The project recognizes glucose control as one of the key components for ensuring optimal care of patients, especially those in the postoperative period,” said Baptist Clinical Pharmacy Specialist Tripp Dixon, PharmD. “Originally, we focused on patients that underwent coronary artery bypass grafting on days one and two following surgery. We achieved intensive glycemic control in these patients and saw decreased infection rates.”

Over 12 percent of hospitalized patients in the US have diabetes included in their discharge diagnoses. Between 30 and 40 percent of all hospitalized patients have hyperglycemia, resulting in hospital stays averaging one to three days longer than for those patients without hyperglycemia. Mississippi is ranked number two in the nation for diabetes, and the number of Mississippians with diabetes has doubled from 1994 to 2010. (See reference)

Baptist began its efforts in 2008. Due to the success of the team with cardiovascular surgery patients, the project has expanded to manage all types of patients with elevated blood sugar. The team receives referrals from a variety of specialty physicians to control patients’ blood sugar from admission to discharge. The goal is to maintain blood glucose levels within the standards set forth by the American Diabetes Association.

“This concept of care is exceedingly novel. It’s truly a collaborative effort where we as pharmacists have the ability to manage insulin therapy and oral diabetes medications,” added Baptist Diabetes Management Pharmacist Anna Baldwin, PharmD. “We work with our patients and their primary care providers to tailor a regimen that works best for them both in the hospital and after they are discharged.”

The diabetes nurse educators train patients on managing their care while dietitians educate patients on dietary habitats and the best nutrition options to help control diabetes long term.

“Diabetes leads to many complications; if we have better control of it while patients are in the hospital, we can reduce their short term risk for adverse events and improve long term quality of life,” added Dixon.

The team’s success led to them receiving the “Innovative Pharmacy Practice Award” during the 2012 Mississippi Society of Health-System Pharmacists annual meeting.

Reference Source:
Moghissi E. Hospital management of diabetes: beyond the sliding scale. Cleve Clin J Med. 2004; 71: 801-8.  Umpierrez GE Isaacs SD, Bazargan N, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocinol Metab. 2002; 87: 978-82.  Mississippi State Department of Health. Diabetes in Mississippi. http://www.msdh.state.ms.us/msdhsite/_static/43,0,296.html (accessed 2012 Sept 11).

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