Baylor Scott & White Medical Center Grapevine
Congratulations to Baylor Scott & White Medical Center Grapevine recipient of the 2026 Bill Aston Award for Quality for its work to reduce hypoglycemia through nurse-led, physician-engaged practice standardization across critical care and step-down cardiac care.
What began as an effort to address rising hypoglycemia rates in the intensive care unit developed into a sustained approach to improving glycemic safety that was successfully replicated in the hospital’s Cardiovascular Unit. Through interdisciplinary collaboration, physician engagement and data-driven practice changes, the initiative strengthened communication and standardized practices across both units.
Identifying Risk at the Bedside
In late 2022, the ICU’s hypoglycemia rate increased from 16.62 to 21.14 events per 1,000 patient days. Clinical nurses worked alongside nursing leadership and physicians to conduct a root cause analysis, identifying NPO status, lack of provider review of trended glucose data, inconsistent nutrition planning and communication gaps during multidisciplinary rounds as contributing factors.
The team redesigned the glycemic portion of the multidisciplinary rounding tool to display trended blood glucose data and empowered nurses to advocate for caloric intake, clarify NPO duration and proactively escalate risk during rounds.
Turning Communication Into Action
Physician engagement was part of the initiative throughout the root cause analysis, tool redesign, provider education and standardization, helping establish consistent practices across the unit.
Following implementation, the ICU’s hypoglycemia rate declined to 12.57 events per 1,000 patient days in the first quarter of 2024 and reached 4.24 by the fourth quarter.
Taking the Model Beyond the ICU
In 2024, the Cardiovascular Unit experienced a similar increase in hypoglycemia. The ICU implementation model was intentionally replicated with CVU clinical nurses, incorporating data tracking, nurse-led chart audits, glycemic trends during multidisciplinary rounds, standardized communication and education.
The CVU achieved sustained improvements beginning in October 2024, including periods with zero hypoglycemic events in 2025 and 2026.
Building a Model for Broader Improvement
The work extended beyond the two units. The initiative was shared through Baylor Scott & White Health councils and evidence-based practice forums, as well as national professional conferences. It also was used to help guide the foundation for standard practice across 52 hospitals in Texas.
Implemented using existing staffing, governance structures and clinical workflows without new capital investment, the initiative created a scalable and replicable approach to reducing hypoglycemia through standardized communication, interprofessional collaboration and data-driven practice changes.
Please join us in congratulating Baylor Scott & White Medical Center – Grapevine on its recognition through the 2026 Bill Aston Award for Quality and its commitment to sustained improvement in patient safety.
Bill Aston Award for Quality:
Academic Institution or Large Teaching Hospital/System
The Texas Hospital Association Bill Aston Award for Quality honors hospitals’ measurable success in improving quality and patient outcomes through the sustained implementation of a national and/or state evidence-based patient care initiative.