T1D Monitoring Project meeting minutes 4/26/24
JDRF T1D Monitoring Project meeting 4/26/24 1:00 PM ET
Participants: Dr. Carla Demeterco-Berggren; Dr. Laura Jacobsen; Dr. Osagie Ebekozien; Ann Mungmode; Don Buckingham
Agenda:
Time | Item | Lead(s) |
2:00-2:10 (10’) | Welcome
· Updates to Qualtrics and QI Portal |
Ann Mungmode |
2:10-2:30 (20’) | Failure Mode and Effects Analysis
· Anticipating and accounting for failures in process development |
Don Buckingham
|
2:30-3:00 (30’) | QI Project Updates
· Process maps · PDSA cycles · Data submissions – Qualtrics |
Dr. Carla Demeterco-Berggren
Dr. Laura Jacobsen |
Minutes:
Welcome and Updates:
- Updated Qualtrics survey; both teams have started uploading surveys
- Some suggested edits:
- Include Insulin AA in multiple AA option (currently in single AA)
- Remove Tyrosine Phosphate (a type of Anti-IA2 which we collect already)
- T1DX team to update Qualtrics
- Laura and Carla to continue survey entry
- Reviewed QI Portal projects
- Can document monitoring projects using “Other” à “T1D Screening and Monitoring” metric
- Laura and Carla to update QI Portal with monitoring projects
Failure Mode and Effects Analysis:
- Why a FMEA tool?
- Document our methods and QI story
- Identify ‘what could go wrong’ and prepare for it before the process is established
- FMEA background
- We use a Fishbone diagram to identify root causes which stand in the way, which help us determine interventions that ARE the way
- Things that we may discover (which severely interrupt process) on the back end of implementation:
- Risk to patient/provider
- Technology failure
- Missing materials
- When this happens, hospitals will often do a root cause analysis
- If the effects of the failure are severe, we will benefit from identifying and incorporating around them in the ‘design’ process
- The magnitude of the risk informs the extend of the FMEA process to go through
- If we experienced a patient death, for example, extensive FMEA would be appropriate
- A supply chain disruption would be a different process
- FMEA components
- Identify the failure modes – what could go wrong
- Indicators tell how how we know if the process failed
- We can rate based on severity
- The intervention would help relieve this failure in the future
- FMEA and this project
- Laura and Carla can decide if this tool is appropriate for this content area
- We brainstormed some potential failures
- Misdiagnosis
- Billing failures
- Mishandling of samples
- Patients decline monitoring options
- As we work on a process, we may have a higher rate of success bias
- Using an FMEA may help with this bias by challenging us to ask how this could fail and how we could mitigate that from happening
- Especially in a high-risk and high reward scenario
QI Project Analyses Updates:
- University of Florida updates:
- Updated process map
- 17 people screened, 8 entered into Qualtrics
- Positivity rate is 50% but probably won’t stay this high
- 7% positivity in relatives
- Rady Children’s updates:
- Updated process map
- Monitor screening inbox
- Offer counseling for every family; seen within two weeks
- Two junior faculty joining this project and working to scale up
- Eventually to general pediatricians
- Providing academic instruction
- Understanding with receiving referrals to endos and sharing flyers
- EMR documentation
- Using family history, or
- Z-code for AA (GAD AA+)
Meeting Recording: T1DX-QI JDRF Monitoring project check-in-20240209_140208-Meeting Recording.mp4
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