PRESENT Diabetes QIP | Quality Improvement Program

PRESENT e-Learning Systems is pleased to offer this innovative and much needed inpatient diabetes management course to hospital systems. This educational program is badly needed as we move towards a pay for performance model. The best practice standards for inpatient management of diabetes are well known. The challenge facing hospital systems is to train their clinicians and compel them to practice to these standards. That's what PRESENT DiabetesQIP does so well.

The DiabetesQIP online inpatient diabetes management course is one of the largest inpatient diabetes management educational interventions to date. Our systematic online approach resulted in a proven level 6 education outcome, defined as an improvement in patient's health attributable to an education activity. The results were published in 4 peer reviewed journal articles^1-4. The online on-demand administration of the course allows for greater flexibility and compliance with work hour regulations, convenience, scalability, and course management.

OBJECTIVE

The objective is to offer a comprehensive online inpatient diabetes management course to hospitals, that has been developed by a renowned academic medical center, and that offers improved knowledge, confidence and patient glycemia metrics as documented in the peer-reviewed medical literature. This online diabetes inpatient management course provides standardized quality improvement training for hospitalists, family practitioners, internists, residents, physician assistants, nurse practitioners and all members of the multi-disciplinary diabetes management team. The program is designed and documented to improve outcomes and avoid medical errors in treating this high-risk patient population. The course was developed in conjunction with PRESENT e-Learning Systems by the Division of Endocrinology and Diabetes at the Icahn School of Medicine at Mount Sinai and delivered using a revolutionary online Learning Management System (LMS) known as PRESENT Mentor™.

BACKGROUND

Diabetes and hyperglycemia multiply the risk for patient readmission within 30 days. As the healthcare system is moving towards a "pay-for-performance model", forward-thinking hospitals are increasingly focusing on reducing readmission rates and improving publicly reported quality markers.

Inpatient hyperglycemia and hypoglycemia are associated with increased mortality, morbidity, and cost. Several organizations have, therefore, developed guidelines to address this important disease state and control costs. Non-adherence to published guidelines, inadequate hypoglycemia precautions, delayed titration of insulin, and improper insulin sliding-scale use are widely prevalent practices associated with worsening dysglycemia. Many physicians (while acknowledging that inpatient dysglycemia is a common problem) profess limited knowledge and motivation to treat it. The modularity and scalability of web-based training enables us to target the appropriate healthcare professionals and provide them with the data and knowledge necessary to identify and treat this growing patient population, while complying with duty hour restrictions. Together with the Icahn School of Medicine at Mount Sinai, PRESENT e-Learning Systems has built one of the largest and most widely adopted, peer reviewed, studied, analyzed and published educational interventions for the treatment of inpatient diabetes.

In a landmark educational program funded by the Endocrine Fellows Foundation, all 116 medicine residents at the Icahn School of Medicine at Mount Sinai (fka Mount Sinai School of Medicine) were randomly assigned to online or classroom training on inpatient dysglycemia in the fall of 2008. The course content was designed by Ron Tamler, MD, PhD, Clinical Director and Clinical Trials Leader, Mount Sinai Diabetes Center, Derek LeRoith, MD, PhD, Chairman of the Department of Medicine, Division of Endocrinology, Mount Sinai School of Medicine, and other endocrinology faculty members. Both groups studied were offered an online refresher course in spring 2009, addressing remaining gaps in clinical practice identified on chart review. The primary outcome measure was the change in patient glycemia on two teaching wards before and after the course.

For 2009/2010, the online curriculum was optimized to emphasize avoidance of hypoglycemia, with updated BG targets. It was offered to the medicine residents and the hospitalists at Mount Sinai Hospital, and they were joined by residents at the Harvard teaching hospital, the Brigham & Women's Hospital in Boston and the University of Maryland, both of whom have been running the program and collecting additional data, to publish their results independently.

All online education in this study was based on the MENTOR™ platform by PRESENT e-Learning Systems, an online platform integrating narrated Powerpoint slides and interactive embedded didactic quizzes that had to be completed to progress through the modules.

OBJECTIVE

BACKGROUND

RESEARCH DESIGN AND METHODS

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