Successful implementation of a perioperative glycemic control protocol in cardiac surgery: Barrier analysis and intervention using lean six sigma

Elizabeth A. Martinez, Raul Chavez-Valdez, Natalie F. Holt, Kelly L. Grogan, Katherine W. Khalifeh, Tammy Slater, Laura E. Winner, Jennifer Moyer, Christoph U. Lehmann

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

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 < 200mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.

Original languageEnglish (US)
Article number565069
JournalAnesthesiology Research and Practice
Volume2011
DOIs
StatePublished - Nov 24 2011
Externally publishedYes

Fingerprint

Total Quality Management
Thoracic Surgery
Critical Care
Intensive Care Units
Intraoperative Period
Glucose
Quality Improvement
Insulin
Education

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

Successful implementation of a perioperative glycemic control protocol in cardiac surgery : Barrier analysis and intervention using lean six sigma. / Martinez, Elizabeth A.; Chavez-Valdez, Raul; Holt, Natalie F.; Grogan, Kelly L.; Khalifeh, Katherine W.; Slater, Tammy; Winner, Laura E.; Moyer, Jennifer; Lehmann, Christoph U.

In: Anesthesiology Research and Practice, Vol. 2011, 565069, 24.11.2011.

Research output: Contribution to journalArticle

Martinez, Elizabeth A. ; Chavez-Valdez, Raul ; Holt, Natalie F. ; Grogan, Kelly L. ; Khalifeh, Katherine W. ; Slater, Tammy ; Winner, Laura E. ; Moyer, Jennifer ; Lehmann, Christoph U. / Successful implementation of a perioperative glycemic control protocol in cardiac surgery : Barrier analysis and intervention using lean six sigma. In: Anesthesiology Research and Practice. 2011 ; Vol. 2011.
@article{eb9641be0ff441aca54c30951050cc81,
title = "Successful implementation of a perioperative glycemic control protocol in cardiac surgery: Barrier analysis and intervention using lean six sigma",
abstract = "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 < 200mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.",
author = "Martinez, {Elizabeth A.} and Raul Chavez-Valdez and Holt, {Natalie F.} and Grogan, {Kelly L.} and Khalifeh, {Katherine W.} and Tammy Slater and Winner, {Laura E.} and Jennifer Moyer and Lehmann, {Christoph U.}",
year = "2011",
month = "11",
day = "24",
doi = "10.1155/2011/565069",
language = "English (US)",
volume = "2011",
journal = "Anesthesiology Research and Practice",
issn = "1687-6962",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Successful implementation of a perioperative glycemic control protocol in cardiac surgery

T2 - Barrier analysis and intervention using lean six sigma

AU - Martinez, Elizabeth A.

AU - Chavez-Valdez, Raul

AU - Holt, Natalie F.

AU - Grogan, Kelly L.

AU - Khalifeh, Katherine W.

AU - Slater, Tammy

AU - Winner, Laura E.

AU - Moyer, Jennifer

AU - Lehmann, Christoph U.

PY - 2011/11/24

Y1 - 2011/11/24

N2 - 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 < 200mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.

AB - 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 < 200mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.

UR - http://www.scopus.com/inward/record.url?scp=81555204110&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=81555204110&partnerID=8YFLogxK

U2 - 10.1155/2011/565069

DO - 10.1155/2011/565069

M3 - Article

C2 - 22091218

AN - SCOPUS:81555204110

VL - 2011

JO - Anesthesiology Research and Practice

JF - Anesthesiology Research and Practice

SN - 1687-6962

M1 - 565069

ER -