Is your site considering Basal Bolus Insulin Therapy?

Change is difficult, and implementing Basal Bolus Insulin Therapy (BBIT) at a site involves so much more than simply releasing an order set for general use. This website compliments the website and has been created to support your core implementation team along this journey. So how do you start?

Step 1: Understand what is involved in implementing BBIT at your site.
  • A document outlining the suggested implementation plan is available here.
  • A video about implementing Basal Bolus Insulin Therapy (BBIT) is also available here:

Step 2: Assemble a core implementation team, consisting of administrative, nursing, pharmacy, physicians and other ordering care provider champions.
  • It is imperative that all multidisciplinary groups listed above are represented.
  • Physician engagement, in particular, appears to be a key factor influencing the success of the project.
Step 3: The implementation team should meet and discuss their site readiness in the pre-implementation/planning phase.
  • A Site Readiness Assessment Tool can be found here, and is intended for sites to use to independently identify areas that should be addressed prior to undertaking the project.
Step 4: Identify what might get in the way, or “Barriers” to implementation.

Teams will encounter many barriers during their pre-implementation, implementation and post-implementation (sustainment) phases. Some barriers will affect the entire hospital, a service, site or unit, whereas others may affect only subsets of providers or units.

Here you will find the most commonly identified barriers to implementing Basal Bolus Insulin Therapy. For each barrier selected on this interactive website, a personalized Toolkit will be generated with suggestions, strategies and specific links to relevant materials to facilitate implementation.

We encourage sites to identify their most common 3-5 barriers, and explore the strategies suggested to address them. Not every tool listed is required to overcome each barrier, and tools were intended to be modifiable to suit the specific needs of each site.

This Toolkit has been designed to be used in an iterative fashion. It is important to re-evaluate barriers on an ongoing basis, even after your site’s “Go-Live” date. After using a tool, we recommend evaluating whether it has been effective, or whether another strategy is required to overcome the barrier.

Sites are encouraged to reach out to the Diabetes, Obesity and Nutrition Strategic Clinical Network if the website, barriers or tools are unclear, or if barriers have arisen that are not currently addressed on the website. We continue to collect feedback, so check back regularly for updates.

Good luck with your implementation!

Determine your barriers to implementing BBIT.

Select barriers that are relevant to your organization and implementation. At the bottom this page, generate your individualized tookit. A PDF of the personalized toolkit can be obtained by clicking Download Personalized Toolkit once complete. Each tool should further facilitate the implementation of BBIT, and help to overcome any barriers to it's adoption.

Culture Barriers

Awareness and Capability barriers

Communication Barriers

System Barriers

Resource Barriers