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Best and Brightest: Building a Team to Fight Diabetes
Enlisting the help of other clinicians at UC Health University Hospital lets staff endocrinologist Mercedes Falciglia improve outcomes for diabetes patients.
My focus is on inpatient diabetes. No matter what they’ve been admitted for—car accident, heart attack, having a baby—about one-third of our 500 hospital patients are diagnosed with diabetes; over one half will be diagnosed with hyperglycemia, or elevated blood sugar. With those who have diabetes, we want to help them get treatment, and with those who have hyperglycemia we want to see if we can intervene before complications arise.
You’d think that in a hospital feeding a patient is one of the easiest things to do. But if you’re trying to make sure the food is delivered, blood sugar is tested, insulin is administered, and the patient eats the meal all within a short period of time, it can be a challenge. I like the challenge and am working with a collaborative, multidisciplinary team to put policies in place to make all areas work together.
This is a relatively new concept in medicine. When I was in med school, the focus was doctor-to-patient. Now the patient has a whole team on her side. Our team includes people from food services, nurses, physicians, endocrine fellows, dieticians, pharmacists, and administrators. We measure metrics and meet weekly to see what other units are doing that affect our protocols. Our program provides the patient with survival skills—how to check her blood sugar at home, when to take medication, what kind of diet to follow, how to administer her own insulin. The goal is for the transition back to normal life to be seamless. It can be hard for patients to absorb it all, especially if they came in for an entirely different reason. So we’d like to expand the program to include communication with primary care physicians—to let them know their patient has the early signs of diabetes so they can intervene.
When I left Cincinnati to get my undergraduate degree at Columbia in New York City, there were so many misconceptions that the Midwest is not progressive. When I came back for medical school at the University of Cincinnati, I was blown away by how open they were to change and making things better. Every time I wanted to try something new I was met with enthusiasm. As a result, the work we’re doing here is having an impact on diabetes treatment nationally.
Originally published in the January 2012 issue.