Herman G. Berkman Diabetes Clinical Innovation Grant Awarded to Improve Inpatient Diabetes Care at UMass Memorial Hospitals
Date Posted: Wednesday, June 05, 2019
The second annual Herman G. Berkman Diabetes Clinical Innovation Fund grant was awarded to endocrinologists Leslie Domalik, MD and Asem Ali, MD, to improve blood glucose control for all patients living with diabetes who get admitted to a UMass Memorial hospital.
It was developed on the premise that adopting a flexible meal dosing option based on carbohydrate counting would improve the outcomes of hospitalized patients. The study will coordinate the appropriate timing of blood glucose testing, insulin dosing, and when rapid-acting mealtime insulin is administered. It will also provide carbohydrate counts for all food within the hospitals and better coordinate insulin delivery with when meals are delivered to patients.
One third of hospital patients in the United States have diabetes or hyperglycemia, and it’s greater than 40% within the UMass Memorial hospitals. Our Blood Glucose Management Service has decreased the length of hospital stays for people with diabetes by 25%. In addition to improving patient outcomes, it has resulted in a multi-million dollar revenue increase. This was accomplished by the UMass Memorial Diabetes Center of Excellence expanding care for all hospitalized individuals admitted with diabetes and providing training to inpatient staff on diabetes-related issues.
“Still, nursing workflow limitations have not allowed for coordination of meal delivery with insulin administration, consistent carbohydrate labeling of the food available to patients, and carb counting before meals, said Dr. Domalik.”
The length of time between blood testing, meal delivery, and insulin administration has been inconsistent. Meal sizes also vary among hospitalized patients. “We’ve identified inpatient rapid-acting insulin dosing as a major area for improvement to better impact patient outcomes,” added Dr. Domalik.
All hospitalized patients with diabetes are learning basic carbohydrate counting and are asked to track their carb intake at the bedside. The project will ensure better communication between dietary services and nursing to improve the coordination of meal delivery and mealtime insulin delivery.
Dr. Domalik is confident that the pilot study will continue to improve the glucose control of all inpatients at UMass Memorial hospitals.
The Berkman Fund was established by UMass Memorial Health Care and the UMass Chan Diabetes Center of Excellence, to support the development of diabetes clinical care initiatives that would not normally find funding through traditional operational expenses or research grants. Herman Gerald Berkman, PhD, believed greatly in the mission and care model of the UMass Chan Diabetes Center of Excellence. His estate provides ongoing support through this fund to continue his appreciation of our commitment to high quality and innovation.
Last year’s inaugural grant was awarded to Daniel Amante PhD and Adarsha Bajracharya, MD. Their project ‘Identifying Diabetes Patients and Leveraging Underutilized Services to Improve Care’ (ID PLUS Care) focused on a multidisciplinary, collaborative approach to improve care access, quality, and management for at-risk patients with diabetes. It monitors Electronic Health Record data to identify UMass Chan Medicare Accountable Care Organization patients at risk for negative outcomes and proactively contacts patients to nudge them toward recommended services.
It led to Dr. Amante (above right) receiving a three-year KL2 Mentored Career Development Training grant to develop a Diabetes Mellitus program using Behavioral economics to Optimize Outreach and Self-management support with Technology (DM-BOOST). It builds upon the Berkman-funded ID PLUS Care by developing tailored approaches to increase patient engagement with diabetes self-management training and using technologies to improve patient outcomes. It will also strengthen the growing collaboration between the Diabetes Center of Excellence, the Department of Population and Quantitative Health Sciences, and the Office of Clinical Integration.