TARGETED INSULIN THERAPY TO IMPROVE HOSPITAL OUTCOMES (TRIUMPH) PROJECT
The Diabetes Program at UCLA, under the leadership of Dr. Sadhu, implemented a new service dedicated to identifying and treating hospitalized patients with elevated glucose to improve mortality, secondary complications, and hospital costs associated with this condition. Studies have shown that hospitalized patients with elevated glucose have worse outcomes, including increased risk of death, infection, kidney failure, heart failure, need for transfusions and nerve damage. Moreover, many patients in these studies were found to have diabetes or pre-diabetes that had been previously neglected or undiagnosed. This program identifies high risk patients in a timely manner, develops safe and effective therapeutic protocols to normalize glucose, and provides education for patients and providers about diabetes and glucose management. The project team, including a physician, two nurses and a diabetes educator, identifies, treats and educates diabetic patients to significantly improve their hospital care as well as the patients’ own ability to manage their health over the long term.
The project also assessed the financial benefits related to decreased hospital costs and shorter lengths of stay as a result of the protocols implemented. Length of Stay (LOS) in the Intensive Care Unit (ICU) was reduced by 1.19 days per admission (with a reduction of $5,231 in total ICU costs). The clinical team calculated a potential ICU cost savings of $5.5 million in the group of patients treated by the TRIUMPH team in the first year after the implementation of the intervention. If project staff and efforts are subtracted from the savings, potential savings associated with the intervention appear to far outweigh the costs.
Dr. Archana Sadhu, the Principal Investigator, also published two articles documenting the results of the project:
“Economic Benefits of Intensive Insulin Therapy in Critically Ill Patients” in Diabetes Care, August 2008
“Hyperglycemia in Hospitalized Patients” Chapter 3, in ACP Hospitalist.
To read the full article published in Diabetes Care, click here