Home Telemonitoring to Reduce Readmission of High-Risk Patients: a Modified Intention-to-Treat Randomized Clinical Trial.

Background: Home telemonitoring has been used with discharged patients in an attempt to reduce 30-day readmissions with mixed results.

Objective: To assess whether home 30-day telemonitoring after discharge for patients at high risk of readmission would reduce readmissions or mortality.

Design: Prospective, randomized controlled trial.

Development of computer-based training to enhance resident physician management of inpatient diabetes.

Background: Treating hyperglycemia promotes better outcomes among inpatients. Knowledge deficits about management of inpatient diabetes are prevalent among resident physicians, which may affect the care of a substantial number of these patients.

Methods: A computer-based training (CBT) curriculum on inpatient diabetes and hyperglycemia was developed and implemented for use by resident physicians and focuses on several aspects of the management of inpatient diabetes and hyperglycemia: (1) review of importance of inpatient glucose control, (2) overview of institution-specific data, (3) triaging and initial admission actions for diabetes or hyperglycemia, (4) overview of pharmacologic management, (5) insulin-dosing calculations and ordering simulations, (6) review of existing policies and procedures, and (7) discharge planning.

Temporal and geographic patterns of hypoglycemia among hospitalized patients with diabetes mellitus.

Background: Hypoglycemia is often cited as a barrier to achieving inpatient glycemic targets. We sought to characterize hypoglycemic events in our institution by work-shift cycle and by specific treatment area.

Methods: Capillary (bedside) and blood (laboratory) glucose values of <70 mg/dl for patients with either a known diagnosis of diabetes or with evidence of hyperglycemia were abstracted from our laboratory database for hospitalizations between October 1, 2007, and February 3, 2008.

Inpatient to outpatient transfer of diabetes care: planing for an effective hospital discharge.

Objective: To review data on diabetes discharge planning, provide a definition of an effective diabetes discharge, and summarize one institution's diabetes discharge planning processes in a teaching hospital.

Methods: We performed a MEDLINE search of the English-language literature published between January 1998 and December 2007 for articles related to the inpatient to outpatient transition of diabetes care. Regulatory guidelines about discharge planning were reviewed.

Diabetes care in hospitalized noncritically ill patients: More evidence for clinical inertia and negative therapeutic momentum.

Background: Little is known about management of hyperglycemia in inpatients.

Objective: To gain insight into caring for hospitalized patients with hyperglycemia.

Design: Retrospective analysis.

Management of inpatient hyperglycemia: assessing perceptions and barriers to care among resident physicians.

Objective: To develop insight into resident physician attitudes about inpatient hyperglycemia and determine perceived barriers to optimal management.

Methods: As part of a planned educational program, a questionnaire was designed and administered to determine the opinions of residents about the importance of inpatient glucose control, their perceptions about what glucose ranges were desirable, and the problems they encountered when trying to manage hyperglycemia in hospitalized patients.

Results: Of 70 resident physicians from various services, 52 completed the survey (mean age, 31 years; 48% men; 37% in first year of residency training).