Glucose Management Clinical Decision Support to Improve Outcomes in Academic and Community Hospitals

What this Trial Is About

Researchers are evaluating the impact of an electronic medical record clinical decision support (CDS) tool on controlling abnormal blood sugar levels, known as dysglycemia, in hospitalized patients with diabetes or stress-related hyperglycemia. The study aims to examine how this tool affects clinical outcomes, hospital costs, and healthcare providers' knowledge and practice performance in both academic and community hospital settings. This research involves non-intensive care patients and explores the tool’s influence on improving hospital care delivery and reducing complications related to high glucose. The study uses an innovative alert-CDS tool integrated into the electronic medical record system. This tool automatically identifies dysglycemia and inadequate insulin use, then sends alerts with treatment recommendations to healthcare providers during active phases of the study. The trial alternates between six active 3-month periods when alerts are sent and six inactive 3-month periods without alerts, covering a total of 36 months. During inactive periods, data on care gaps are collected but alerts are not shown. This setup allows comparison between standard care and care supported by the alert-CDS tool. Participants include adult patients hospitalized or receiving ambulatory care at several hospitals within the health system. The study tracks multiple outcomes such as hospital length of stay, glycemic control measures, rates of complications, mortality, hospital resource use, and economic impacts. Provider perspectives and decision-making related to dysglycemia management are also assessed through surveys. The total observation period spans up to three months per hospital admission, with some measures extending up to a year after discharge.

Diabetes Clinical Decision Support