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EPIC enhancements for stroke patients with diabetes bridge gap in care

19 May 2024

See tip sheets, SBAR; started May 15

By: Sarah Daniels, RN, stroke navigator

Several EPIC enhancements for Primary Stroke Center Certification Compliance went live May 15 to help improve care for stroke patients with diabetes. They will bridge a gap in care identified during the recent Joint Commission Primary Stroke Center survey. See SBAR and tip sheets below:


During the Joint Commission Primary Stroke Center survey, a gap was identified in the management of stroke patients with diabetes. During the chart review, several stroke patients were identified who had a high A1C and did not receive a nutrition consult during their hospital admission or a referral for outpatient management of their diabetes. 


One of the standards set by The Joint Commission to be a Primary Stroke Center requires the management and treatment of patients’ comorbidities and co-occurring conditions. Currently, an A1C is not collected on all stroke patients and there is not a process for nutrition consults during admission or outpatient referrals for diabetes management.


A standardized process is needed to ensure all stroke patients are evaluated for diabetes. To ensure compliance with the Primary Stroke Center standard, there needs to be a process to provide inpatient nutrition consultation and outpatient referral for diabetes management for patients with an elevated A1C.


To close this gap, the stroke order sets will have A1C preselected. A BPA will fire, for the provider, if the patient’s A1C is over 9 to place the “MD Consult to Nutrition Services – Nutrition Assessment” order.  When the Discharge Navigator is started, a second BPA will be activated if the patient’s A1C is over 8 to place the “Referral to Diabetes Education” order. This process will make sure that all stroke patients with an elevated A1C receive the proper consultation during their admission and outpatient follow-up for diabetes management.



  • American Diabetes Association releases 2023 standards of care in diabetes to guide prevention, diagnosis, and treatment for people living with diabetes. American Diabetes Association Releases 2023 Standards of Care in Diabetes to Guide Prevention, Diagnosis, and Treatment for People Living with Diabetes | ADA. (n.d.).

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