We would like to thank Dr. Cattano for his comments regarding our article, “A Perioperative Systems Design to Improve Intraoperative Glucose Monitoring Is Associated with a Reduction in Surgical Site Infections in a Diabetic Patient Population.”1 Our local implementation of the glucose bundle primarily focused on (1) implementation of intraoperative decision support, (2) departmental agreement around the utility of intraoperative glucose monitoring, and (3) broadened availability of intraoperative glucose point-of-care testing. The implementation of this bundle was a free-standing initiative, not linked to any other quality improvement initiatives that occurred during the study time course. Glycosylated hemoglobin (HgbA1C) was only available for a subset of patients: 810 (20%) preintervention and 3,088 (26%) postintervention. HgbA1C was therefore not included in the propensity score because matching on HgbA1C resulted in a dramatic decrease in the number of matched pairs.
The author declares no competing interests.