July 2023 Pediatric Collaborative Call

Jul 11 Peds Collaborative Call 2023 Combined Final (1)

Pediatric  Collaborative Call Meeting Minutes

July 11, 3:30-5:00pm

• Welcome & introductions
• Updates from the Collaborative
  • We currently have 55 Participating Clinics, 35 Pediatric & 20 Adult
  • Welcome Children’s Medical Center, University of Texas
    • PI: Abha Choudhary, MD
  • November Learning Session
    • November 14-15, New York City, NY
    • T1DX-QI will cover the hotel costs for 2 team members
    • Abstracts due by 7/31/23; accepted abstracts will be published in Journal of Diabetes
  • Q2 2023 Invoicing
    • Reminder: submit invoices for January-June 2023 deliverables
  • ADCES
    • We would love to see you if you plan on attending the ADCES conference in Houston, TX, August 4-7
    • Please email qi@t1dexchange.org if you plan on attending
  • T1DX-QI Annual Survey: survey will be released on 7/13/23
    • Each clinic should submit 1 completed survey
    • Abstract and Manuscript opportunities from data collected
    • 25 minutes or less to complete
    • Responses due by 8/23/23

• Clinical Presentation: Le Bonheur Children’s Hospital, Grace Nelson, MD
  • Learning Objectives:
  • Discuss baseline data for pump use at LBCH
  • Look at reasons for low pump use
  • Discuss PDSA cycles and outcomes to improve pump use
  • Discuss next steps
• Increasing equitable pump use
• Baseline data identified an opportunity to improve equity (6% NHB versus 25% NHW using pump)
• Previously, clinic culture required a number of steps, training, preparation before prescribing an insulin pump
• Described pain points in a process map and root causes in a Fishbone diagram
• Tried several tests of change (for example, loosened pump guidelines, implicit bias training, educate staff on pump technology)
• For non-White patients with A1c > 9% that were targeted for project, team has documented improvement in A1c by two points after 9 months on insulin pump
• Using My Diabetes Journey and new Diabetes Technology Form
• Increasing pump use and closing equity gap (for patients coming into clinic)

• Clinical Presentation: University of Indiana, Tamara Hannon, MD
  • Learning Objectives:
    • Review national incidence of DKA in youth with established diabetes
    • Review rationale for integrating a structured program to improve outcomes in patients following an episode of DKA.
    • Share what did/did not work for us in creating a structured follow-up program for youth who presented in DKA to try and help reduce risk for repeat DKA.
  • Integrated Diabetes Education and Support (IDEAS) Program to reduce repeat DKA
    • Wanted to address rates of DKA due to the severe possible consequences
    • Organize resources and support for patients with T1D who were admitted for DKA
    • Used a Fishbone diagram to identify root causes and key driver diagram to identify change ideas
    • Tried several tests of change (started the program, learned from and adjusted appointment for flexibility and scheduling, incorporate sick day education as a part of annual diabetes education)
    • Sick day and technology stations available with supply kits and resources for patients
    • Patients had a consultation with LMSW, several had reduced A1c, and only one had a DKA episode after participating in the program

Next meeting: Thursday September 21^st 11-12:30pm EST

Link for meeting recording:

https://us02web.zoom.us/rec/share/ZGA92jmFIa-XJdkBMypXanFPEWUXpbLrVQj-7kec0799ZDu8CEWf8X4OCBBZSvDy.3Cet6pwnzBedNRxn?startTime=1689103886000

Passcode: u5p2+Lfm