QI in Action: Reducing Hospital-Acquired Hypoglycaemia
We spotlight Grace Matthews’ quality improvement project, which focuses on reducing hospital-acquired endocrine complications, specifically hypoglycaemia, at Broken Hill Hospital.
The ACHS Improvement Academy’s Quality Improvement Lead (QIL) Program supports healthcare professionals in implementing data-driven improvement initiatives within their organisations.
QIL Graduate, Grace Matthews’ project titled, 'Reducing Incidents of Hospital acquired Endocrine Complications: Hypoglycaemia,' that addressed system wide gaps to improve health outcomes at Broken Hill Hospital in the Far West Local Health District (LHD).
Broken Hill Hospital is a 98-bed rural teaching hospital offering a wide variety of services, including 24-hour emergency and maternity services, as well as general medicine, surgical, paediatric, dialysis, oncology, acute mental health, operating theatre, specialist palliative care, intensive and coronary care units.
Project Background
Hospital-acquired hypoglycaemia remained a persistent issue at Broken Hill Hospital. Over an eight-month period, the hospital consistently exceeded the Far West LHD target of 21.8 hospital-acquired hypoglycaemia episodes, triggering concerns from the district board and safety and quality subcommittee.
The majority of hypoglycaemia cases involved fasting patients who were not receiving appropriate glucose monitoring and management. Moreover, 60% of affected patients were known diabetics who had been administered incorrect intravenous (IV) fluids, increasing their risk of hypoglycaemia.
Addressing Causes of Hypoglycaemia
Further investigation identified system-wide gaps contributing to these preventable complications:
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Lack of clear, standardised guidelines on managing hypoglycaemia in hospitalised patients.
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Outdated policies that were not being consistently applied.
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Poor communication about hypoglycaemia risk, particularly during safety huddles.
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Inconsistent documentation, making it difficult to track trends and intervene early.
To address these gaps, the project team used a series of interventions aimed at standardising care, improving education, and strengthening communication. A new hypoglycaemia management flowchart was developed to guide clinicians in monitoring and managing glucose levels in fasting patients. This ensured that staff had clear protocols to follow, reducing variability in care.
To ensure clinicians could easily access the updated hypoglycaemia guidelines, the policy and flowchart were integrated into the Med App, a mobile platform widely used by healthcare professionals. This provided a quick reference tool at the point of care.
The hospital’s leadership team and quality and safety committee have recognised this project as a model for future QI initiatives. Given its success, Far West LHD is now exploring ways to apply similar improvement methodologies to reduce other hospital-acquired complications.
Explore projects from QIL Program Graduates
You can read more projects like this in the QIL Projects Summary booklet undertaken by QIL 2021-2023 participants over the course of our 9-month program.
The booklet contains summaries of real work-based improvement projects across various healthcare categories including acute healthcare, community, drug and alcohol services, partnering with consumers and more. Project Summaries booklets are available for viewing here.
