Equity Expansion Monthly Meeting: Meeting minutes 02.07.2025
Attendees: Timothy Bol, Mark Clements, Christine Byer-Mendoza, Emily DeWit, Susan Hsieh, Andrea Huber, Emma Mason, Kimberly McNamara, Tatiana Nisenboym, Katie Noland, Ori Odugbesan, Stephanie Ogburn, Nicole Rioles, Madison Saalinger, Simran Shikh, Devin Steenkamp, Francesco Vendrame, Wendy Yang, Candice Williams
Introductions: Ori provided an overview of the project and timeline and presented the progress of targeted interventions in improving CGM use at select centers. Sample CGM & pump interventions were shared. Overall, the goal of the group was to validate successful interventions for long term sustainability, and by providing demonstrated improvements for nearly all targeted interventions. The project’s success was demonstrated by sharing CGM use by ethnicity and pre & post intervention for BDC, BMC, CMH, Cook Children’s, Michigan, and Rady Memorial. This information will be published by Q2, so please send us your outstanding deliverables as soon as they are available.
Discussion occurred about the next steps for submitting manuscripts and the publication committee timeline.
Rady Children’s Hospital: Christy Byer-Mendoza presented on their center’s actions to increase CGM adoption. Removing requirements for starting on a pump, addressing referrer biases, hosting educational classes, offering bi-lingual assistance, and offering educational materials in more languages than English.
A control chart was shared which demonstrated the successes of their interventions and their progress. Challenges and lessons learned were also shared. Next steps involve more education on pumps, involving medical students, and training a Spanish speaking educator to lead those classes.
Discussion occurred about the statistical significance of the control chart’s data points.
Cook Children’s Hospital: Candice Williams presented their center’s goals of improving CGM use in all patients. Ethnic minority demographic information was shared and how it related to increased CGM discussion over their 30 day intervention. A run chart of improved numbers of active PWT1D using CGM was shared. SDoH data was approved and will be available this week. Dashboard data was provide and Ori requested charts to be shared.
Barbara Davis Center: Emma Mason presented results from their interventions to improve access to diabetes devices for their minority patients. Baseline data was shared for both CGM and pump use. Three major barriers to the adoption of technology were shared for CGM and pumps. Key highlights were shared with barriers being costs, anxiety of change, and keeping appointments. Provider buy-in was mentioned as a specific barrier at their site. Control charts showing modest improvements in CGM and pump use were shared while mentioning that there is still room for improvement. Next steps involve lowering cancellations/DNKs and looking at improving educational materials and implementing a SDoH Questionnaire to address multiple barriers.
University of Miami: Dr. Francesco Vendrame presented on reducing inequities in diabetes technology devices using among PWT1D. A diabetes technology and barriers assessment survey was provided to 2210 patients of all ethnicities and payers. Data from their center showing the differences in AID and people not using AIDs as well as an Aim Statement to increase by 5% the use of Smartpens (SIP) among people on CGM only which would work out to an increase in ~7 new users.
Interventions to implementing the use of SIPs was shared, including educating clinicians, guidance with prescribing, setting up training, and expanding the number of clinicians involved. Through these interventions, the target of the Aim statement was achieved; however proper PDSA cycles were unable to be tested due to the length of time between prescribing and training. People with good diabetes control using CGM are less likely to start the use of SIPs, but these barriers are theoretically modifiable but difficult to overcome.
Children’s Mercy Hospital: Emily was not in attendance and Katie was unable to present.
Closing: Ori reminded the group of the importance of participating in upcoming special projects and to be on the lookout for any communications regarding them.
Presentations from the Closeout Meeting:
Equity Cohort 2 Close out January 2025
T1DEx Equity Group – January 2025
Meeting Recording:
Passcode: &4F.*%Qb
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