MUSC Awarded Joint Commission Certificate for Distinction for Advanced Inpatient Diabetes Care

On July 21, 2011, MUSC was awarded Joint Commission Advanced Inpatient Diabetes Certification for Main Hospital, Ashley River Tower, Institute of Psychiatry, and Children’s Hospital. There is one other large academic institution that has this distinction, the University of Minnesota. Additionally some university affiliate hospitals and one VA hospital in Cleveland, Ohio have achieved this award. MUSC is approximately the 40th hospital in the US to gain this distinction.

The Joint Commission Inpatient Diabetes Certification Program is founded on the American Diabetes Association’s Clinical Practice Recommendations and is linked to the Joint Commission Certification Standards. Diabetes currently affects 25.8 million people in the US and another 79 million Americans are estimated to have pre-diabetes. At MUSC in FY2010, there were 34,442 hospital discharges and in FY2011 (up to April 2011), there were 28,044 hospital discharges. For the percent of discharges with a diagnosis of diabetes, ICD-9 codes: 249.XX and 250.XX, approximately twenty percent of inpatients at MUSC have a diagnosis of diabetes. On a daily basis at MUSC medical center, there are approximately 130-150 in patients with a diagnosis of diabetes. The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, the medical record identifies diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes.

The Joint Commission Certification for Inpatient Diabetes Care was accomplished by a multidisciplinary approach involving many areas of MUSC Hospital. Key individuals involved in the process from the Center for Clinical Effectiveness and Patient Safety are: Patrick Cawley, MD, MBA, Hospital Executive Medical Director, Mary-Eliese Merrill, MA, RN, Director of Clinical Effectiveness, Christopher Rees, MA, MBA, Director of Quality and Patient Safety, Pam Arnold, MSN, APRN, CDE, Program Manager for the Diabetes Management Service and Vice Chair of the Hospital Diabetes Task Force, Angela Strickland, RN, Hospital Certified Diabetes Educator (CDE), and Amy Hutto, RN, Hospital CDE. Other important areas of input included: nursing services, pharmacy, dietary services, laboratory medicine, information technology, anesthesia, representatives from MUSC Main Hospital, Ashley River Tower, Children’s Hospital, and Institute of Psychiatry. Heather Kokko, PharmD, Director of Pharmacy Services, Yusheng Zhu, PhD, James Madory, DO, and Nina Epps, MS, from Pathology and Lab Services, and Mary Basel, MNS, RD and Ashleigh Ricevuto, RD, from Dietetic Services, all provided valuable input in this process. Special thanks go to Dr. Louis Luttrell, Division Director of Endocrinology, members of the Diabetes Management Service (DMS): Drs. Louis Luttrell, Soonho Kwon, Jyotika Fernandes, Beatrice Hull, the Endocrine Fellows and the DMS mid-level providers: Sarah Kimble, PA, Kelly Taylor, PA, and Meredith Wince, NP. Also thanks to Drs. Bill Moran, Rogers Kyle, Danielle Scheurer, the MUSC Internal Medicine Program and the MUSC Hospitalist Program. Collaborative efforts occurred with Drs. David Cole, Chairman of the Department of Surgery, Deborah Bowlby, Director of Pediatric Endocrinology, Stephen McLeod-Bryant, Service Line Director for Psychiatry, and Jill Mauldin, Service Line Director for Women’s Services. Additionally, of great importance are members of the Hospital Diabetes Task Force who have given their input and guidance on various diabetes issues, on a monthly basis since 2003. Dr. Jack Feussner was always a source of inspiration for his visionary goals and foresight regarding the care of the patient with diabetes. Thanks to our Joint Commission team: Lois Kerr, Kathy Wade, and Terri Ellis, who always brought relevance to our goals for improving diabetes care. Overall, we had only one recommendation for improvement from Joint Commission which involved hypoglycemia recheck in thirty minutes from initial blood glucose (BG), BG less than 70 mg/dL, or BG recheck within fifteen minutes from treatment.

In conclusion, achievement of certification regarding inpatient diabetes care implies that MUSC has the critical elements to attain success in the care of patients with diabetes. It may be used as a designation for the community that MUSC delivers quality care to our patients. Ultimately, maintaining compliance with these national standards and performance measurement tools may assist with acquiring contracts from employers and purchasers associated with controlling costs and enhancing productivity. This is a distinction that will continue to inspire MUSC to excel in offering safe and effective patient care of the highest quality and value.

Message from Kathie Hermayer, MD, MS, FACE,
Director of Diabetes Management Service
Chair of Hospital Diabetes Task Force

10-01-2011 12:40 (EDT)