A MULTICENTER STUDY EVALUATING PERCEPTIONS AND KNOWLEDGE OF INPATIENT GLYCEMIC CONTROL AMONG RESIDENT PHYSICIANS: ANALYZING THEMES TO INFORM AND IMPROVE CARE

• Type of Material: Article
• Authors: William B. Horton, University of Virginia; Sidney Law, Emory University; Monika Darji, University of Chicago; Mark R. Conaway, University of Virginia; Mikhail Akbashev, Emory University; Nancy T. Kubiak, University of Louisville; Jennifer L. Kirby, University of Virginia; S. Calvin Thigpen, University of Mississippi
• Language: English
• Date: 2019-12-01
• Publisher: American Association of Clinical Endocrinology
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.4158/EP-2019-0299
• Title of Journal or Parent Work: Endocrine Practice
• Volume: 25
• Issue: 12
• Start Page: 1295
• End Page: 1303
• Grant/Funding Information: None declared
• Keywords: Hyperglycemia; Program; Quality instrument; Life Sciences & Biomedicine; Intervention; Computerized order set; Outcomes; Science & Technology; Hospitalized patients; Medical education research; Glucose management; Endocrinology & Metabolism; Team
• Research Categories: Health Sciences, Health Care Management; Education, Health; Health Sciences, Medicine and Surgery

Abstract

Objective: In this descriptive study, we evaluated perceptions and knowledge of inpatient glycemic control among resident physicians. Methods: We performed this study at four academic medical centers: the University of Mississippi Medical Center, University of Virginia Health System, University of Louisville Health Sciences Center, and Emory University. We designed a questionnaire, and Institutional Review Board approval was granted at each institution prior to study initiation. We then administered the questionnaire to Internal Medicine and Medicine-Pediatric resident physicians. Results: A total of 246 of 438 (56.2%) eligible resident physicians completed the Inpatient Glycemic Control Questionnaire (IGCQ). Most respondents (85.4%) reported feeling comfortable treating and managing inpatient hyperglycemia, and a majority (66.3%) agreed they had received adequate education. Despite self-reported comfort with knowledge, only 51.2% of respondents could identify appropriate glycemic targets in critically ill patients. Only 45.5% correctly identified appropriate inpatient random glycemic target values in noncritically ill patients, and only 34.1% of respondents knew appropriate preprandial glycemic targets in noncritically ill patients. A small majority (54.1%) were able to identify the correct fingerstick glucose value that defines hypoglycemia. System issues were the most commonly cited barrier to successful inpatient glycemic control. Conclusion: Most respondents reported feeling comfortable managing inpatient hyperglycemia but had difficulty identifying appropriate inpatient glycemic target values. Future interventions could utilize the IGCQ as a pre- and postassessment tool and focus on early resident education along with improving system environments to aid in successful inpatient glycemic control. (Endocr Pract. 2019;25:1295–1303)