SHM Converge Scientific Abstract ePoster Gallery-Clinical and Therapeutic Inertia in Inpatient Diabetes and Hyperglycemia Management

Pdf Summary

This poster reviews clinical inertia and therapeutic inertia in inpatient diabetes and hyperglycemia management, meaning failure to follow or adjust treatment despite guideline-based opportunities to do so. The authors conducted a literature search of PubMed, CINAHL, and EMBASE through December 31, 2021, identifying 14 peer-reviewed studies on this topic.<br /><br />Overall, the evidence suggests that inpatient glycemic management is often suboptimal. Common problems included underuse of basal insulin, overreliance on sliding-scale insulin, poor glycemic control, and limited attention to discharge planning and post-hospital transitions. Some studies also showed persistent hypoglycemia or hyperglycemia, indicating both undertreatment and overtreatment risks. In many cases, point-of-care glucose data did not clearly translate into better clinical decisions.<br /><br />The included studies were mostly observational, often retrospective chart reviews, and were highly heterogeneous in design, measures, and outcomes. Most were from academic medical centers in the United States, with limited representation of other hospital types, populations, or settings. CTI was rarely distinguished from intentional clinical judgment or patient preference, which limits interpretation. Newer glucometric measures were also inconsistently reported.<br /><br />The authors conclude that only a small fraction of inpatient glycemic management is guideline-concordant. They argue that greater awareness is needed among providers and that future guidelines should explicitly address clinical and therapeutic inertia as barriers to inpatient glycemic control.

Asset Subtitle

Nickie Burney

Meta Tag

Author List Jeffrey L. Schnipper, Nickie Burney

Category Research

Concept Clinical Inertia

Concept Inpatient Diabetes Management

Concept Hyperglycemia

Concept Glucose Management

Concept Guideline Adherence

Distinguished Non-Finalist

Presenter Organization Brigham & Women's, Brigham & Women's Faulkner, Boston College

Presenting Author Nickie Burney

Track Patient Safety

Keywords

clinical inertia

therapeutic inertia

inpatient diabetes

hyperglycemia management

glycemic control

sliding-scale insulin

basal insulin

hypoglycemia

discharge planning

guideline-concordant care

Clinical Inertia

Inpatient Diabetes Management

Hyperglycemia

Glucose Management

Guideline Adherence