This episode of Key In to Quality explores Mayo Clinic’s journey to improve inpatient hypoglycemia management. An initial prevention-focused protocol led to unintended overtreatment, prompting a data-driven revision. The team shares lessons in collaboration, clinical judgment, and continuous improvement. They highlight how thoughtful protocol design can strengthen patient safety and reduce harm.
This episode examines a hospital-wide hypoglycemia management protocol at Mayo Clinic. Recognizing the serious impact of inpatient hypoglycemia, a multidisciplinary team launched a prevention-focused protocol inspired by 2020 ADA guidelines.
Their initial strategy was to intervene at glucose levels below 90 mg/dL to prevent low blood sugar before it occurred. However, real-world data revealed unintended consequences. Many patients between 70–90 mg/dL were not at true risk for hypoglycemia, resulting in overtreatment, unnecessary IV dextrose and glucagon use, increased costs, and strain during a national dextrose shortage.
Hear how the team navigated these challenges, highlighting key quality improvement lessons.
Hosts: Timothy Morgenthaler, MD and Sheri Nemec, MS, CPXP
Guests:
Sneha Mohan MD, Associate Consultant, Endocrinology, Diabetes and Metabolism
Marny Carlson, M.S., R.N., NPD-BC, Nursing Education Specialist
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