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The Duke POET diabetes pathway was planned based on the importance of excellent perioperative glucose control and the reported incidence of poor glucose control observed at Duke University Medical Center ( 1) and in the wider literature. Improvement in perioperative glucose control may therefore lead to improved outcomes in surgical patients. This evidence highlights the need for preoperative diabetes screening programs, since uncontrolled diabetes, whether known or undiagnosed, is a potentially modifiable risk factor. Furthermore, the severity of these complications is often much worse in patients with perioperative hyperglycemia but undiagnosed diabetes ( 5). Perioperative hyperglycemia has been strongly linked with mortality, as well as many surgical complications such as urinary tract infection, ileus, and surgical site infection ( 7). Apart from diagnosed diabetes, undiagnosed diabetes has been seen in up to 10–12% of surgical and inpatient populations ( 3– 5), and perioperative hyperglycemia has been reported in 20–40% of general surgery patients and 80% of cardiac surgery patients ( 6). A recent meta-analysis that included studies involving all types of surgical procedures reported a prevalence of previously diagnosed diabetes of 17% ( 1), and up to 25% of coronary artery bypass patients were found to have known diabetes ( 2). Describe the specific quality gap addressed through the initiative.īoth known and undiagnosed diabetes are common in the surgical population and have been associated with important and possibly preventable surgical complications. This effort included plans for improvements to the electronic health record (EHR) system and its integration with continuous data monitoring capabilities.

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( 1), POET underwent a series of steps in designing this program, including starting with a supportive discussion followed by a business case rationalization and multidisciplinary workstream redesign. As described in more detail by Setji et al. POET was initially formed in 2013 to enhance overall perioperative care through a disciplined care reengineering process. The PASS Clinic serves as the central referral corridor for the Perioperative Diabetes Management Program, a part of the Perioperative Enhancement Team (POET), through which the Endocrinology Department receives notice of patients with unknown or poorly managed diabetes who require rapid access to presurgical diabetes care. The PASS (Perioperative Anesthesia and Surgical Screening) Clinic is a specialized preoperative clinic with a focus on perioperative value enhancement by individualized presurgical screening, situational risk assessment, and optimization of chronic comorbid medical conditions. You can invite colleagues and team members into your EndNote library – including notes and annotations.Duke University Medical Center is an academic, tertiary-care setting in Durham, NC, that serves a broad referral base. It is developed by the prestigious media company Thomson Reuters.ĮndNote moves you through the research process as you search, organize, write, publish and share.

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EndNote stands out over other referencing software because of its easy to use and wide applicability. It is very helpful in bibliography management.

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