How Christus St. Michael Health System helps patients improve glycemic control, quit smoking presurgery

Christus St. Michael Health System in Texarkana, Texas, used two presurgery checklists from the American College of Surgeons' Strong for Surgery program that helped them engage patients in improving lifestyle factors that could have increased their risk for postoperative complications.

Used along with a quality improvement program, the checklists helped increase the number of patients who quit smoking as well as the number of diabetics who achieved better control of blood sugar levels prior to their procedures.

The checklists help clinicians more effectively screen patients for risk factors that can increase the likelihood of surgical complications. They target four areas: nutrition, glycemic control, medication management and smoking cessation.

Researchers studied 385 patients seen in Christus St. Michael's preoperative clinic between July 2017 and January 2018. They studied glycemic control and smoking cessation prior to and after the checklist intervention was implemented.

Prior to implementation, 87.7 percent of diabetic patients showed blood glucose levels less than 200 mg/dL on the day of their operations. Six months after implementation, 97.31 percent of diabetic patients had achieved proper glycemic control by the day of their procedure.

Patient-reported outcomes show 10.5 percent of tobacco users quit smoking before their operations after the checklist intervention was initiated.

Christus St. Michael researchers presented their findings at the ACS 2018 Quality and Safety Conference, July 21 to 24, in Orlando, Fla.

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