Statistical analysis of national subcutaneous insulin chart pilot data
Australian Commission on Safety and Quality in Health Care
Duration: March – September 2016
The Australian Commission on Safety and Quality in Health Care was undertaking a pilot study of a recently developed standardised subcutaneous insulin chart which was designed to facilitate insulin prescribing and management in hospitals. On the new chart all relevant information is recorded in one place, i.e. prescriptions, orders, monitoring and administration. Previously, hospitals implemented local documentation rules with insulin documentation potentially spread across different forms. It was hoped that improved and simplified documentation would reduce risks associated with insulin management for acute inpatients.
CASiH was commissioned to undertake the accompanying statistical analysis. Audit data was collected at six sites across the country at two points in time, before introduction of the insulin chart and after introduction. In total, 379 patients were included, having had 6,729 blood glucose levels tests taken and 1,004 insulin orders recorded.
What we did
Upon receipt of the data CASiH team members worked closely with the Commission to improve the quality of the audit data. The data analysis included a number of statistical tests and subgroup analyses for the different participating sites. Additionally, CASiH provided guidance in interpreting the results. The main findings were that the standardised chart was beneficial for acute inpatients with diabetes. It reduced errors in prescribing and administration and did not result in inferior blood glucose control.
The results of the work fed into a final report by the Commission which is anticipated to be released in the first half of 2017.