Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma

Table 1

CSICU glucose protocol timeline.

Phase and Date	Primary intervention	Study period
Baseline	Nursing assessment via survey. Measure admission glucose level in CSICU	1/8/03–6/27/03
Phase 1 (7/25/03)	OR protocol (begin insulin for glucose >180 mg/dL)*	8/15/03–11/29/03
Phase 2 (12/15/03)	CSICU nursing education and implementation of new CSICU glycemic control protocol	1/12/04–4/15/04
Phase 3 (5/1/05)	OR protocol (begin insulin for glucose >150 mg/dL)*	5/15/05–8/12/05
Phase 4 (9/1/05)	Introduction of revised CSICU protocol	10/7/05–12/31/05
Phase 5 (2/1/06)	OR protocol (begin insulin for glucose >120 mg/dL)*	2/16/06–6/15/06
Final (11/1/06)	OR protocol (begin insulin for glucose >100 mg/dL)*	2/19/07–3/31/07

*Goal admission glucose <200 mg/dL.