Presentation Details
| Implementing Structured Documentation and Education to Improve Perioperative Management of Automated Insulin Delivery Systems Megan J Ott1, Zahid Iqbal2, Tyler Hoffman2, Andjela Drincic3, Shubham Agarwal3, Casey Vlach3, Troy S Wildes2. 1University of Nebraska Medical Center, College of Medicine, Omaha, NE, USA.2University of Nebraska Medical Center, Department of Anesthesiology, Omaha, NE, USA.3University of Nebraska Medical Center, Department of Internal Medicine, Omaha, NE, USA |
Abstract
BACKGROUND: An increasing proportion of patients with diabetes use electronic diabetes devices, including automated insulin delivery (AID) systems, which may pose intraoperative safety risks if not managed appropriately. Although best-practice recommendations for perioperative management exist, practical methods for effective implementation in the preoperative clinic remain undetermined. To address this gap, we designed and implemented a structured process to improve preoperative clinic provider education, clinician decision-making, electronic health record (EHR) documentation, and written patient instructions related to AID and continuous glucose monitor (CGM) use.
PURPOSE: A multidisciplinary team designed a standardized process integrated into the EHR for patients evaluated at the preoperative clinic at a single regional hospital. The process included: a preoperative decision-making flowsheet for managing patients’ devices; an EHR element capturing device parameters, preoperative management decisions, and intraoperative care guidance; and standardized selectable patient instructions for variable circumstances. The documentation tool was designed to capture unique, clinically relevant aspects of the device’s functionality, including device configuration, AID modes, and sensor integration, that meaningfully influence perioperative decision-making. By incorporating this level of granularity, the intervention supports consistent, informed management across diverse and unfamiliar device platforms. Pre- and post-implementation surveys of preoperative clinic APPs will assess changes in knowledge, confidence, and perceived usability in preoperative management of AID and CGM systems.
RESULTS: Pre- and post-implementation surveys of preoperative clinic APPs will be analyzed to assess the impact of the intervention.
CONCLUSIONS: A standardized process for implementing best practices for managing and documenting electronic diabetes treatment devices, such as AID systems, is feasible in the preoperative clinic setting. Feedback from preoperative clinic providers will inform usability and further improvement opportunities. We anticipate that this structured approach to this challenging clinical management paradigm will improve provider confidence and consistency in perioperative diabetes device management and may be a candidate for wider dissemination.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
PURPOSE: A multidisciplinary team designed a standardized process integrated into the EHR for patients evaluated at the preoperative clinic at a single regional hospital. The process included: a preoperative decision-making flowsheet for managing patients’ devices; an EHR element capturing device parameters, preoperative management decisions, and intraoperative care guidance; and standardized selectable patient instructions for variable circumstances. The documentation tool was designed to capture unique, clinically relevant aspects of the device’s functionality, including device configuration, AID modes, and sensor integration, that meaningfully influence perioperative decision-making. By incorporating this level of granularity, the intervention supports consistent, informed management across diverse and unfamiliar device platforms. Pre- and post-implementation surveys of preoperative clinic APPs will assess changes in knowledge, confidence, and perceived usability in preoperative management of AID and CGM systems.
RESULTS: Pre- and post-implementation surveys of preoperative clinic APPs will be analyzed to assess the impact of the intervention.
CONCLUSIONS: A standardized process for implementing best practices for managing and documenting electronic diabetes treatment devices, such as AID systems, is feasible in the preoperative clinic setting. Feedback from preoperative clinic providers will inform usability and further improvement opportunities. We anticipate that this structured approach to this challenging clinical management paradigm will improve provider confidence and consistency in perioperative diabetes device management and may be a candidate for wider dissemination.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
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