Equity Expansion Monthly Meeting: Meeting minutes 10.4.2024
Equity Expansion Monthly Meeting: Meeting minutes 10/4/2024
Attendees – Timothy Bol, Christy Byer-Mendoza, Ashley Garrity, Kimberly McNamara, Ori Odugbesan, Stephanie Ogburn, Francesco Vendrame, MD, Candice Williams
Updates from the previous meeting were provided.
October Equity Update: Increasing InPen Usage – New PDSA Cycle.
Kimberly presented on trialing a process for newly diagnosed teenage patients.
Details about the process were shared: the plan is to identify two newly diagnosed patients to start on INPEN.
Discussion occurred around the planning state of that particular PDSA.
Francesco Vendrame, MD detailed his group’s experience with the TEMPO Pen.
Ashley mentioned that one downside of the TEMPO Pen is it’s availability only being for adults; however, the NOVO pen is available for pediatrics. Unfortunately, availability is an issue. Through the course of the discussion, it was suggested using the terminology of “Smartpen” instead of using brand names.
Candice Williams provided an update on a CGM A PDSA chart involving meeting with an educator at time of diagnosis. Follow-up is scheduled for November/December. Positive changes have already been realized. Analysis of the diabetes educator survey was provided as well as an announcement that a new data analyst has been added to the team.
Analysis of Disparities between public and private insurance CGM prescriptions was shared.
- Patient demographic improvements were shared.
- There is concern that pump use has not significantly improved this calendar year – an epic rollout and provider drift were provided as reasons for this lack of improvement.
A suggestion was made to add “Non-Hispanic Whites” to the total.
Dr. Vendrame provided an update to a barrier assessment survey. A case was made for using automated insulin delivery devices for achieving better glycemic control compared to using CGM alone.
Advice for discussion to implement the use of Smart Insulin Pens was provided. He feels a 40% success rate would be considered successful.
Suggestions for improving patient compliance was solicited: Medrontic was suggested by Christy Byer-Mendoza, and utilizing their Representatives for assisting patients. Kimberly suggested a monthly remote learning session for patients; however, one was previous trialed, but patients didn’t show up.
“Was learning about a new device?” a barrier to entry was asked Ashley. It was suggested that messaging and education should be tailored directly to patients.
Ashley Garrity provided an update: 98% of t1d patients now have CGM; however, consistent use is still an ongoing issue. 2% of population is non-white but there has been some improvement in that population.
Patients are being asked at point of care which devices they are using and the standardizing of those meetings has been a tribute to the program’s success. They have lower pump use than CGM. The pump has a steeper learning curve and hopes to use lessons learned from CGM and apply them to pumps.
Candice inquired with the group if there’s a mixed message paper to clear up poor messaging occurring with patients. She worries about the feasibility of publishing such information as it could considered negative for the institution. Ashley says it is publishable, and suggested pooling information and collaborating between institutions as it would take the pressure off of any particular institution. Ori asked if any other teams are interested, and doing some qualitative analysis by getting a on a call or two for further discussion. Kimberly said they have done a lot of work at her organization, and it has successfully improved outcomes doing so.
A link to a recording of the video is below:
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