Several EPIC enhancements for Primary Stroke Center Certification Compliance went live May 15 to help improve care for stroke patients with diabetes. They will bridge a gap in care identified during the recent Joint Commission Primary Stroke Center survey. See SBAR and tip sheets below:
During the Joint Commission Primary Stroke Center survey, a gap was identified in the management of stroke patients with diabetes. During the chart review, several stroke patients were identified who had a high A1C and did not receive a nutrition consult during their hospital admission or a referral for outpatient management of their diabetes.
One of the standards set by The Joint Commission to be a Primary Stroke Center requires the management and treatment of patients’ comorbidities and co-occurring conditions. Currently, an A1C is not collected on all stroke patients and there is not a process for nutrition consults during admission or outpatient referrals for diabetes management.
A standardized process is needed to ensure all stroke patients are evaluated for diabetes. To ensure compliance with the Primary Stroke Center standard, there needs to be a process to provide inpatient nutrition consultation and outpatient referral for diabetes management for patients with an elevated A1C.
To close this gap, the stroke order sets will have A1C preselected. A BPA will fire, for the provider, if the patient’s A1C is over 9 to place the “MD Consult to Nutrition Services – Nutrition Assessment” order. When the Discharge Navigator is started, a second BPA will be activated if the patient’s A1C is over 8 to place the “Referral to Diabetes Education” order. This process will make sure that all stroke patients with an elevated A1C receive the proper consultation during their admission and outpatient follow-up for diabetes management.
References:
Contact sarah.daniels@salemhealth.org or syed.kazmi@salemhealth.org.