Key result
Lean Six Sigma perioperative insulin protocol boosts CSICU glycemic control to >90%.
Why the study?
There is scant literature describing the practical application of perioperative glycemic control protocols in the complex ICU environment for cardiac surgical patients.
Does the implementation of a perioperative insulin protocol using Lean Six Sigma methodology improve glycemic control upon CSICU admission in cardiac surgical patients?
Does the implementation of a perioperative insulin protocol using Lean Six Sigma methodology improve glycemic control upon CSICU admission in cardiac surgical patients?
The use of Lean Six Sigma methodology to implement a perioperative insulin protocol successfully and significantly improved glycemic control upon CSICU admission for cardiac surgery patients.
Answers are grounded in this paper and cite their sources.
Lean Six Sigma implementation improved CSICU admission glucose control; hypothesis-generating for outcome benefits in cardiac surgery.
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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Martínez et al. (2011) studied Cardiac surgery. Perioperative insulin protocol using Lean Six Sigma vs. Preintervention was evaluated on Admission to the CSICU with glucose <200 mg/dL. Implementation of a perioperative insulin protocol using Lean Six Sigma increased the proportion of cardiac surgery patients admitted to the CSICU with glucose </dL from <10% to >90%.
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