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SRMC ramps up diabetes care
Medical center receives rare certification for its inpatient diabetes care program
By Julie Marsh Contributing writer
Posted March 17, 2010 at 11:23 p.m.
http://www.redding.com/news/2010/mar/17/srmc-ramps-up-diabetes-care/
Photo by Greg Barnette
Shasta Regional Medical Center Registered Dietitian and Certified Diabetes Educator Joanne Tippin talks with her patient Dean Harkrader Monday, March 1, about his diabetes. The two were discussing low blood sugar and setting goals to prevent it.
Shasta Regional Medical Center has become the first hospital in California to receive a certification for inpatient diabetes care from the Joint Commission, a nonprofit group that accredits and certifies health-care organizations.
Only the 11th hospital in the nation and the first in the state to meet the rigorous standards of the Joint Commission, SRMC has been working toward the certification for several years, according to Joanne Tippin, a registered nurse and certified diabetes educator at SRMC, the protocol.
Three years ago the hospital expanded the services offered in its Outpatient Diabetes Care Center from medical nutrition therapy to a full diabetes care management program certified by the American Diabetes Association, Tippin said.
While most patients don't enter the hospital for diabetes, Lou Castillo, registered nurse and certified diabetes educator, said that about 30 percent of SRMC's patients have the disease.
The majority of hospitals use a sliding scale model to treat diabetes. In this model, blood sugar is treated only after it goes too high. According to Dr. Mitchell Akman, an endocrinologist and expert in treating diabetes, this is the opposite of how the body should work.
SRMC has moved to a managed care model where blood sugars are kept under tight control. According to Castillo, research has shown this model to have better outcomes.
"Better outcomes mean decreased infection rates, decreased length of stay and decreased risk factors of other diseases," Castillo said. "Inflammation processes don't work like they should when blood sugar is high. High blood sugar also creates a perfect environment for infection."
Added Akman: "The bottom line is the patients do better and heal quicker. No one wants to be in the hospital. It is better for everyone."
A steering committee that included Akman, Tippin and Castillo began working on the program in 2007. Castillo said extensive, hospital-wide training took place that included nurses, physicians, pharmacists and dietary staff.
"Diabetes is a disease that is treated as a team - it all ties together," Akman said.
The hospital had the entire program in place by January 2009. After fine-tuning the program for almost a year, Tippin said the chief nursing officer, Cyndy Gordon, said it was time to call the Joint Commission for certification.
Gordon said the inpatient diabetes care program is about continually improving patient care.
"We do it because we want to be the best at what we do," Gordon said. "To do that you need to have someone come in and verify that you are doing what you need to do and can tell you if there is something else you could do better."
According to SRMC Chief Medical Officer Dr. Marcia McCampbell, the Joint Commission, also known as JACO, is the entity that the government relies on to say whether hospitals meet standards.
"JACO accredits hospital and specialty programs," McCampbell said. "The Inpatient Diabetes Care is a very strict accreditation."
This accreditation requires monthly monitoring, ongoing training and monthly reports submitted to JACO.
"The journey has just begun," Castillo said. "This isn't something you get and forget about. It is an ongoing process."
Tippin said the reward for the extra work lies with the patients.
"We have patients call back after they have been sent home and they are so appreciative," she said. "We impacted someone in a positive way. From a health care standpoint it feels good to go the extra mile."
Julie Marsh is a freelance writer in Redding.
About the certification
The Joint Commission said its Certificate of Distinction for Inpatient Diabetes Care recognizes hospitals that make exceptional efforts to foster better outcomes across all inpatient settings. The Joint Commission and the American Diabetes Association have identified that the most successful inpatient diabetes programs possess the following critical attributes:
Specific staff education requirements.
Written blood glucose monitoring protocols.
Plans for the treatment of hypoglycemia and hyperglycemia.
Data collection of incidences of hypoglycemia.
Patient education on self-management of diabetes.
An identified program champion or program champion team.
According to the Joint Commission, achievement of certification signifies that the services provided by the hospital have the critical elements to achieve long-term success in improving outcomes.
Source: The Joint Commission: www.jointcommission.org