The implementation of a coordinated, multidisciplinary model at UC Davis Health has led to significant and sustainable improvements in inpatient glycaemic management without increasing the incidence of hypoglycaemia, a study published in Diabetes, Obesity, and Cardiometabolic Care reports.
System-wide strategy reduced variation in diabetes care
The initiative, led by the Multidisciplinary Diabetes Care Committee (MDCC) at UC Davis, shifted inpatient diabetes management from ad hoc individual consultations to an organised, centre-wide programme of care. The paper describes a phased rollout across the medical centre designed to strengthen infrastructure, align clinical practice and embed safety-focused processes across nursing, pharmacy, endocrinology and frontline teams.
“Improving inpatient diabetes care requires more than individual interventions. It takes a coordinated, system-wide commitment to patient safety, clinical excellence, and multidisciplinary collaboration,”
Joseph M. Galante, chief medical officer at UC Davis Medical Center, said the study demonstrates how teamwork across disciplines produced better outcomes for hospitalised patients while mitigating the risks associated with both hyperglycaemia and hypoglycaemia.
Core elements of the UC Davis model
The study identifies several key elements of the programme that contributed to improved glycaemic outcomes. These components were implemented together as part of a structured, phased strategy rather than as isolated fixes.
- Inpatient Glycaemic Team: an active consult service dedicated to managing inpatient diabetes care;
- Standardised insulin order sets: orders with embedded clinical decision support to reduce prescribing errors and variability;
- Multidisciplinary glucose-management rounds: routine collaborative review of patients’ glucose control;
- Unit-based diabetes nurse champions: frontline nursing leads to sustain practice change on wards;
- ICU insulin infusion protocol: co-managed with pharmacists to ensure safe insulin infusion practice in critical care;
- Performance dashboards: glycaemic data and insulin administration metrics to monitor outcomes and guide improvement;
- Ongoing education: continuous training for physicians, trainees and staff to maintain competence and adherence to protocols.
| Programme component | Purpose |
|---|---|
| Inpatient Glycaemic Team | Provide specialised, timely diabetes care across wards |
| Standardised order sets | Reduce variability and embed decision support |
| Dashboards | Track performance and enable data-driven improvement |
According to the report, these interventions together improved blood‑glucose outcomes across the medical centre while avoiding a rise in hypoglycaemia, a central patient-safety concern in hospital settings.
Implications for hospitals and clinicians
The UC Davis experience underlines that improving inpatient diabetes care relies on organisational commitment, clear processes and multidisciplinary collaboration. The study suggests that single interventions—while useful—are less likely to produce sustained gains than an integrated model that addresses clinical workflow, prescribing practices, frontline ownership and performance measurement.
For hospitals seeking to reduce glycaemic complications, the following lessons emerge from the study:
- Embed clinical decision support within standardised orders to decrease prescribing variation;
- Establish a dedicated inpatient diabetes service to provide expertise and continuity;
- Empower nursing champions to maintain day‑to‑day adherence to protocols;
- Use data dashboards to monitor outcomes and target improvement efforts.
While the report comes from a US academic medical centre, the underlying principles—systems leadership, multidisciplinary teamwork, standardisation and routine measurement—are applicable in diverse hospital settings, including in South Africa. Implementing such a model requires resources, leadership commitment and sustained staff education, but the study indicates these investments can improve patient safety without increasing the risk of dangerous low blood sugar.
Clinicians and managers interested in adapting these approaches should review the full study in Diabetes, Obesity, and Cardiometabolic Care and consult relevant local guidelines. Patients with diabetes or carers who have concerns about inpatient glucose management should speak to their treating clinician, clinic or hospital team rather than self‑adjust medicines.
