Your Resource for HQIC News and Learning Opportunities | Dec. 2022
Glycemic Management 
An adverse drug event (ADE) is an injury resulting from medical intervention related to a drug.1 ADEs are among the most preventable causes of death in hospitals, and ADEs involving hypoglycemic agents comprise 57 percent of all ADEs—making this the largest drug class contributing to ADE-related harms.

Beginning January 2023, the Centers for Medicare & Medicaid Services (CMS) will ask hospitals to collect ADE data using two new glycemic management electronic clinical quality measures (eCQMs).
  • Severe hypoglycemia will be measured as the percent of patient stays in which blood glucose is less than 40 mg/dL within 24 hours of administration of hypoglycemic medication(s).2
  • Severe hyperglycemia will be measured as the percent of hospital days with one or more blood glucose levels greater than 300 mg/dL, excluding the first 24-hour period after admission or a day in which a blood glucose test was not done, and it was preceded by two consecutive days in which at least one glucose value during each of the two days was greater than or equal to 200 mg/dL.3
It Figures: Data Performance
The data show improvement in glycemic management ADEs from the baseline to the current time period (lower rates are better). Visit the HSAG HQIC Quality Improvement Innovation Portal (QIIP) to view your data by selecting the “Measure Category” of Adverse Drug Events and the “Measure” of ADE Diabetic Agent.
* Rates are per 1,000 admissions.
Source: Claims data. For additional details on measure specifications, please reference the HSAG HQIC Compendium of Measures. The baseline time period is 01/01/2019–12/31/2019 and current time period is 07/01/2021–06/30/2022.
The Flash: Resources
Diabetes Zone Tool
Using easy-to-understand language, this tool for patients allows primary care providers to customize blood sugar goals and has a safety checklist to pinpoint problems before they become emergencies.
Hypoglycemic Event Analysis Tool (HEAT)
This comprehensive, investigative tool includes questions regarding the patient's diet, insulin, and myriad contributing factors to explore following a hypoglycemic event.
Glycemic Management Roadmap to Success
This step-by-step document can assist quality improvement teams with strategies to prevent and treat inpatient glycemic events—with participation from frontline staff, nursing leadership, diabetes educators, hospitalists, pharmacists, and more.
Critical Communication
Sepsis Mortality
Sepsis is one of the top causes of death worldwide and the most common cause of death for intensive care patients.4 Every hour of delay in tailored antibiotics (targeting the most likely pathogen) equates to a 7.6 percent increased likelihood of mortality.5 Patients with sepsis often experience stress-induced hyperglycemia. These same patients may experience hypoglycemia following strict glycemic control for stress-induced hyperglycemia. Both hyperglycemia and hypoglycemia increase the likelihood of mortality.4

Consider using the Sepsis Mortality Toolkit in addition to the glycemic management tools and resources listed in The Flash section to improve survivability of sepsis. 
Events and Education
Health Equity
Quickinar Series
Achieving equitable care for all patients is a key priority for CMS, which is reflected in the new Hospital Commitment to Health Equity Structural Measure and Social Drivers Screening Measures in the Final Rule. These short, 30-minute presentations address the many facets and criteria hospitals will need to meet for these measures, and will assist your hospital in advancing health equity initiatives in alignment with CMS priorities.

Begins Thursday, January 12, 2023 | 1 p.m. ET
Phase 2: Care Coordination Quickinar Series
Continue your care coordination journey for managing avoidable hospital readmissions by registering for Phase 2 of the quickinar series. These short, 30-minute webinars are offered monthly through July 2023. Find recordings for past presentations on the quickinar webpage.

Next webinar: Tuesday, January 10, 2023 | 2 p.m. ET
References
1 Kohn LT, Corrigan JM, Donaldson MS (Institute of Medicine). (2000). To err is human: building a safer health system. Washington DC: National Academy Press. 
2 eCQI Resource Center. Hospital Harm – Severe Hypoglycemia. (August, 2022). https://ecqi.healthit.gov/ecqm/eh/2023/cms816v2  
3 eCQI Resource Center. Hospital Harm – Severe Hyperglycemia. (August, 2022). https://ecqi.healthit.gov/ecqm/eh/2023/cms871v2   
4 Wang J, et al. (July 2021). Hypoglycemia and mortality in sepsis patients: A systematic review and meta-analysis. Heart & Lung. https://www.sciencedirect.com/science/article/abs/pii/S0147956321002363
5 Kumar et al. (2006). Duration of hypotension before initiation of effective antimicrobial therapy is the critcal determinat of survival in human septic shock. Crit Care Med. https://journals.lww.com/ccmjournal/Abstract/2006/06000/Duration_of_hypotension_before_initiation_of.1.aspx
This material was prepared by Health Services Advisory Group (HSAG), a Hospital Quality Improvement Contractor (HQIC) under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication No XS-HQIC-XT-12062022-1