Preferred Name
Dawn Byrne
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
ORCID
0009-0007-3178-7933
Date of Graduation
12-13-2025
Semester of Graduation
Fall
Degree Name
Doctor of Nursing Practice (DNP)
Department
School of Nursing
First Advisor
Jeannie Corey, DNP, RN, NEA-BC, FAAN
Abstract
Diabetes is a prevalent and costly public health concern, affecting over 38 million adults in the United States and contributing significantly to hospital admissions and chronic healthcare complications. With the Centers for Medicare and Medicaid Services (CMS) introducing new electronic clinical quality measures (eCQMs) for inpatient diabetes management, hospitals face potential financial penalties for failing to control hyperglycemia and hypoglycemia. A retrospective analysis conducted in November 2024 of a community hospital in Northern Virginia revealed suboptimal glycemic control, with high rates of hyperglycemic (18.6%) and hypoglycemic (2.2%) events, placing the facility at risk of CMS penalties.
This project aimed to align the organization’s outcomes with the CMS guidelines for hyper and hypoglycemia to enhance patient safety while reducing potential financial liability associated with poor metric performance. This quality improvement clinical research project followed the Institute for Healthcare Improvement (IHI) Plan-Do-Study-Act methodology to enhance glycemic management within a 100-bed medical-surgical service line in a community hospital. Key initiatives involved improvement in interdisciplinary communication among dietary and clinical nursing staff. Interventions included analyses of meal tray delivery workflows, point-of-care testing (POCT), and insulin turnaround times (TAT). Communication enhancements were implemented using application-based technology and smartphone integration. Data collection included quantitative and qualitative methods to assess the effectiveness of the applied interventions.
Research suggests that improved interdisciplinary communication, through application-based strategies and clinical smartphone technologies, can enhance coordination of meal tray delivery, point-of-care testing turnaround time, and insulin administration timelines. This quality improvement initiative focused on optimizing communication workflows to improve glycemic outcomes. With the CMS eCQM reporting becoming mandatory in 2026 and potential penalties reaching 2.5% of CMS reimbursement, a proactive approach and intervention are critical for patient safety and organizational financial stability.
As a result of these interventions, in conjunction with work from a fellow Doctor of Nursing Practice (DNP) project focused on nursing practice change in insulin administration workflow, the organization demonstrated measurable improvement in glycemic management outcomes.
Keywords: Diabetes, Point-of-Care, eCQM, Communication, Smartphone, Meal Delivery
