ArticleBMJ open2026
Variation and knowledge translation gaps in day-of-surgery glycaemic management by anaesthesiologists: a qualitative exploration of a quality gap in Canadian hospitals.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
importanceDay-of-surgery hyperglycaemia is a modifiable risk factor for adverse patient outcomes including infection and 30-day mortality. Despite these risks, important quality gaps in day-of-surgery glycaemic management have been demonstrated in multiple settings.
objectiveTo describe barriers and facilitators to high-quality glycaemic management from the perspective of anaesthesiologists.
designThis qualitative study was designed using two implementation frameworks, the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR), to understand individual and organisational drivers and barriers to high-quality glycaemic management by anaesthesiologists. A patient partner with type 1 diabetes mellitus who had undergone surgery in our setting participated in study design and analysis.
settingFour academic hospitals within a single provincial (Alberta) healthcare system in Canada.
participantsAnaesthesiologists practising at any academically affiliated hospital in Edmonton or Calgary, Alberta, Canada.
interventionsOne-on-one semi-structured interviews exploring day-of-surgery glycaemic management. MAIN OUTCOME AND MEASURES: Deductive thematic analysis of one-on-one interviews with anaesthesiologists was based on the TDF and CFIR.
resultsSaturation was reached after 13 interviews. There was important between-provider variation within the TDF constructs of CONCLUSIONS AND RELEVANCE: Quality improvement interventions meant to improve day-of-surgery glycaemic management should address between-anaesthesiologist variation in glycaemic management processes and targets.
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