February 15, 2008

Innovative approaches to clinical obstacles

Established in 2006 to help bridge the gap between new clinical evidence and current clinical practice, the MGH Clinical Innovation Awards support physicians, nurses and allied health professionals with an interest in applying their knowledge and creativity to improve day-to-day patient management at the hospital. Recently, Enrico Cagliero, MD, of the MGH Diabetes Center, (below right) and John Patrick T. Co, MD, MPH, of the MGH Center for Child and Adolescent Health Policy and the MGH Revere HealthCare Center, (below left) were named the 2007 Clinical Innovation Award recipients. Their projects were selected from among 21 proposals.

Cagliero's project evaluates the efficacy of an electronic set of insulin orders for improving glycemic control in MGH inpatients, nearly a third of whom have diabetes. Poor blood sugar control in a hospitalized patient is associated with dehydration, electrolyte imbalances, an increased frequency of infections and worse outcomes with heart attack and strokes, which all can lead to an increased length of stay and in-hospital mortality. Cagliero hopes to optimize care for diabetic inpatients during their stay at the MGH by improving overall glycemic control while minimizing hypoglycemic events.

Co's project will evaluate the effect of decision support on
managing neonatal hyperbilirubinemia, also known as newborn
jaundice. Improper management of this condition can result in permanent neurologic and cognitive deficits in children. Providing guideline-adherent management is problematic due to the need for access to both maternal and infant clinical information, as well as the use of specific graphical calculating devices to guide treatment and follow up. In conjunction with David Berkowicz, MD, and Henry Chueh, MD, both of the MGH Laboratory of Computer Science, Co is developing a software application that integrates maternal and newborn medical information and reports bilirubin results graphically in the context of current guidelines. The effectiveness of the software application will be tested in a randomized controlled trial.

For more information about the MGH Clinical Innovation Awards, contact Kay Ryan, director of the MGH Clinical Research Program, at (617) 724-5200.