Clinical Study
Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma
Table 2
Retrospective evaluation of glucose data by project phase.
| | | Baseline | Phase 1 | Phase 2 | Phase 3 | Phase 4 | Phase 5 | Final | P value |
| Patients | n | 390 | 221 | 267 | 221 | 204 | 279 | 310 | — | Glucose datapoints | n | 3778 | 2505 | 11063 | 13255 | 13509 | 18180 | 19043 | — | Datapoints/ patient/day | Mean (±SD) | 3 (±2) | 3 (±2) | 8 (±3) | 12 (±5) | 11 (±5) | 11 (±5) | 12 (±4) | <0.001a | Admit glucose (mg/dL) | Median (IQR) | 160 (67) | 144 (56) | 161 (57) | 144 (58) | 136 (57) | 133 (49) | 124 (48) | <0.001b | Admit glucose <200 mg/dL | % (n) | 76 (297) | 89 (197) | 81 (217) | 87 (192) | 90 (184) | 95 (266) | 94 (291) | <0.001c | TWGL (mg/dL) | Mean (±SD) | 141 (±26) | 133 (±27) | 129 (±22) | 116 (±12) | 112 (±11) | 111 (±11) | 111 (±11) | <0.001a | Median (IQR) | 138 (32) | 129 (37) | 129 (20) | 115 (15) | 110 (11) | 109 (14) | 109 (13) | <0.001b | Time to glucose control (hr) | Median (IQR) | 16 (22) | 15 (17) | 12 (11) | 11 (10) | 9 (9) | 10 (8) | 9 (8) | <0.001b | Glucose 6 h control | % (n) | 0 (0) | 0.5 (1) | 7.1 (19) | 4.5 (10) | 5.9 (12) | 8.6 (24) | 11 (34) | <0.001c | Hypoglycemia events | % (n) | 1.7 (63) | 1.5 (38) | 1.5 (168) | 1.2 (161) | 0.7 (90) | 0.9 (160) | 0.9(173) | <0.001c | Hypoglycemic patients | %(n) | 9.5 (37) | 10.9 (24) | 21.3 (57) | 23.1 (51) | 21.6 (44) | 16.8 (47) | 19 (59) | <0.001c |
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aOne-way ANOVA; bKruskal‐Wallis ANOVA; cChi‐square. IQR: Interquartile range; Max: maximum; : number of patients; SD: standard deviation; TWGL: time‐weighted glucose levels.
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