Weill Cornell QI Check-In 1/31/2024 1:00 PM eastern
Participants: Emily Coppedge, Isabel Reckson, Dr. Zoltan Antal, Dr. Alyson Weiner, Elizabeth Gunckle, Ann Mungmode
| Agenda |
Notes |
Next steps |
| Jan 2024 Dashboard review |
- Team noticed that one of their POC machines was reported elevated A1c (by 1.5%)
- Working to resolve
- Dec data only includes labs
- Other implications for A1c data:
- New initiative to see high-risk patients more regularly (every six weeks) so they will be counted more frequently
- New transfers to Cornell care (who are established patients with T1D but haven’t been seen by Cornell yet)
- Team noticed that Jan mean HbA1c was 8.8
- So far, T1DX dashboards are seeing anything outside of normal variation for A1c, but we will keep an eye on this and keep this in mind
- TIR still looks good; can rely less on A1c
- Time Below Range – suggestion to make this the inverse (to support identification of patients who are experiencing hypoglycemia)
- Behavioral health
- Finding that team is making BH referrals but patients are not making it to the BH appointment
- As the T1DX-QI evolves, how can we best capture this as a meaningful measure for comprehensive, whole-patient care? I.e., what does an increase in depression screenings mean for our patients?
- Track PHQ-9 scores over time to see changes in scores? (average change in PHQ-9 score by patients)
- Current BH referral Smartsheet measure does not capture the breadth of BH referring occurring at the clinic level; it is specific to patients that were due for depression screening
- Team can compare their T1DX-QI Dashboard to other centers data by using the QI Portal Compare tab!
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- Ann to check with Anton about what is needed to transfer OMOP files
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| QI Projects and QI Portal Improve tab |
- Team has done a great job uploading PDSAs to the QI Portal
- Two new projects added:
- Team has developed an initial process map; can add pain bursts as they are identified
- First PDSA is simple with an N of 1 😊
- Will screening patients with PHQ-9, SDOH, eating disorder, and diabetes distress as a part of their annual visit
- Team to reconsider SMART aim
- Recommendation to review baseline data, including data on specific to the aim but also the distribution of patient ages (i.e., 16-18, 18-21, 21+ for example)
- Team has an idea to identify age-appropriate milestones to prepare for transition, which will eventually be incorporated into Epic
- Team can finalize and close out two projects:
- Mental Health Screening (depression screening project has been completed; team has moved on to screening in annual visit)
- HCLS (can update with presentation and data, and close out – great work team!)
- Family Focus Group is not a QI project so much as a new implementation; suggestion to remove from QI Portal
- That way can focus on the key projects for this year
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- Cornell team to update QI projects, including closing out finished projects and further incorporating data into QI project documentation
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| Next Check-In |
- Next combined Collaborative call 4/18 at 11am ET
- Next QI check-in 5/1 at 1pm ET
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