Equity Expansion Monthly Meeting: Meeting minutes 11.1.2024

Equity Expansion Monthly Meeting 11.01.24

Attendees – Timothy Bol, Christy Byer-Mendoza, Mark C, Luke Cielonko, Georgia Davis, Davis, Emily DeWit, Ashley Garrity, Susan Hsieh, Andrea Huber, Kim McNamara, Emma Mason, Katie Noland, Ori Odugbesan, Alisha Virani, Candice Williams

Christy Byer-Mendoza shared slides regarding their group’s Insulin Pump Therapy Update, a pre-pump checklist. An insulin pump class prep sheet was created as 50% of patients referred to pump class do not move forward.

The plan to increase adoption of pump use includes scheduling visits, offering in person meetings on weekends, zoom twice a month, calling patients 2 weeks post class to remind them to complete the process. A lot of the patients reported they were not ready.

Discussion occurred about barriers to entry: people are afraid of the test, (addressed by calling it a “knowledge assessment.”) Asking patients at the end of the class to see if they are interested in moving forward – if they are not, ask them follow-up questions to determine why. A lack of information sharing before the class can set unfair expectations for the users. Defining difference between interest and readiness. Ask them for degrees of interest? Very, a little, not at all, unsure? Getting people to interact with the device. Virtual classes, while more convenient, are less engaging and effective. Parents are receptive to pumps; however, teenagers are hesitant due to bullying and other issues, which can be mitigated by peer support: patients are introduce to one another to help lower inhibitions about devices.

Ori shared a Diabetes Technology Attitude Shared Decision Tool Questionnaire, which generated interest among the group. Christy suggested producing effective videos and among ideas that are under consideration. There is substantial interest among the group in video production but the rules about patient confidentiality are challenging to navigate.

Alisha and Georgia from Grady shared their project attempting to improve CGM access before and after classes. Three different PDSA cycles improved both rates above range and rates below range. Conclusion: patients enjoy this type of information session, its more effective than information packets, and peer to peer counseling is an opportunity for future growth. Issues of concern include minority patients not knowing anyone else like them who have diabetes in addition to complications from health insurance.

Katie and Emily from CMH shared their Quality Improvement Success Story where a provider is prompted to indicate if a conversation about offering technology when a patient not using technology is seen in clinic. When patients miss appointments, patients are outreached. These steps led to decreased lost to follow-up (LTFU) rates by 25%.Next steps will include continuing to utilize this process. Ori would like the group to tie this program to either smart pens or pumps. They will look at LTFUs and see which of these patients progressed to CGM.

Candice from Cook Children’s shared a success story about educating providers about patient bias in addition to using Peaks Tech Zone, which is available in clinic now on weekdays. Improvement from baseline was 88% and as a result will continue to work with Peak Tech Zone. Ori asked for this document to be finalized and sent to us. Candice said it will be ready before they leave for Chicago.

Emma Mason from BDC shared a success story about reducing percentage of patients with diabetes who had an A1c >9 in non-white patients and increasing device rates in these minority populations. Project started with a questionnaire identifying barriers to devices, questionnaire showed that patients were not doing well with follow-ups so as a team they decided to increase follow up visits which was success