Diabetes and Hyperglycemia Quality Improvement Efforts in Hospitals in the United States: Current Status, Practice Variation, and Barriers to Implementation

Objective: To determine the status of diabetes and hyperglycemia quality improvement efforts in hospitals in the United States.Methods: We designed and administered a survey to a convenience sample of hospitals, and the responses were analyzed statistically.Results: We received 269 responses from 1,151 requested surveys. The sample was similar to hospitals in the United States on the basis of hospital type and geographic region (P = no significant difference) but not on the basis of number of beds (P<.001). Among responding hospitals, 39%, 21%, and 15% had fully implemented inpatient diabetes and hyperglycemia quality improvement programs for critically ill, non-critically ill, and perioperative patients, respectively. Moreover, 77%, 44%, and 49% had fully implemented protocols for hypoglycemia, hyperglycemic crises, and diabetic ketoacidosis, respectively. Variations in glucose target ranges were noted. The responding hospitals had no standard biochemical definition of hypoglycemia; 47% defined hypoglyce...