April 2025 Combined Adult and Pediatric Call
April Combined Adult and Pediatric Collaborative Call Meeting Minutes
April Combined Call FINAL April 15, 2025 3:30-pm EST
- Updates from T1DX-QI Coordinating Center, Nicole Rioles, MA
- Clinical center presentations
- Mount Sinai, Adult, New York, NY, Suma Gondi, MD
- Nemours Children’s Health, Jacksonville, FL, Jennifer Pfieffer, APRN
- Annual Survey Update, Dhruvi Vora, BS, T1D Exchange, Boston, MA
- Hybrid Closed Loop Working Group Update, Carol Levy, MD, CDCES and Trevon Wright, MHA
- Updates from the T1D Exchange:
- Welcome to Arkansas Children’s. Dr. Jurhee Freese provided an overview of their center based out of Little Rock, AR, and the surrounding area. Dr. Freese is the PI for T1D and Dr. Heba Al Ayash is the PI for T2D.
- The T1DX-QI Breakfast at the June ADA Scientific Sessions in Chicago will take place at 7-8am on Sunday, June 22nd. Details will be shared next month.
- The 2025 Learning Session will take place in Atlanta, GA from November 11-12. The hotel location will be shared in the next month with a link for registration shared by 6/1. T1DX will cover the costs of two hotel nights for two guests.
- T1D Exchange has opened a call for abstracts for the November learning Session: QI Collaborative clinics are invited to submit abstracts, which will be considered for publication in the Journal of Diabetes as well as for oral or posters presentations at the November Learning Session. Please use this link for abstract submission.
- T1D Exchange is now accepting proposed questions for the 2025 Annual Survey. Please share your questions by 5/2. Clinics are welcome to submit 4-8 questions. Please share your survey questions to QI@t1dexchange.org and cc: nrioles@t1dexchange.org and tbol@t1dexchange.org
- Statements of Work ending in June. Please invoice T1D Exchange by May 31, 2025. All invoices must be received before 6/1/2025.
- Consult your SOW for deliverable details.
- Include terms/timelines of deliverables, PI name, and amount in your invoice.
- Please include bank account name & address.
- Email invoice to: Linda Crasco linda.crasco@t1dexchange.org ; Rene Weathers rweathers@t1dexchange.org ; T1D Exchange Accounts Payable: t1dxap@t1dexchange.org
- Questions about invoicing can be sent to Nicole Rioles nrioles@t1dexchange.org
- Clinic Presentations: Mount Sinai, Suma Gondi, MD
- Dr. Gondi provided an overview of their center and introduced their topic: Improving Equitable Access to Technology in PwT1D.
- Baseline Data was collected for 12 months from July 23-24 from two locations; patients were identified using Billing/CPT codes and insurance status.
- Patient demographic and technology utilization information was analyzed and results showed that prescribing was lowest for Medicare patients and inequity was highest at Mt. Sinai Hospital.
- Fellows were surveyed about their level of comfort in prescribing tech and the survey results informed actionable items to those barriers.
- A KDD was created to find barriers to prescribing technology, which included Material, Patient, Environment, and Prescriber domains.
- A process map was developed and multiple PDSAs were implemented.
- Cycle 1: interventions with Fellows; Cycle 2 focus on CDCES; Cycle 3 focus on patients; Cycle 4 focus on Preceptors; Cycle 5 using MyChart messages to follow up after CDCES visits
- Interventions were reassessed, and assigned to: adapt, adopt, or abandon. Next steps and future ideas were shared.
- Discussion: great to see fellows doing this work, shared decision-making tools, and plans to analyze the number of patients continuing with technology after initiation.
- Nemours Children’s Health, Jacksonville, Monica Mortensen, DO, and Jenny Pfieffer APRN, PCNS-BC, ESMHL
- Dr. Monica Mortensen provided an overview: The Importance of Transition Programs for Young Adults with Diabetes.
- Jenny Pfieffer presented on the challenges in helping young people with diabetes transition to adult care and shared some barriers to helping with that transition: resource limitations, lack of education, lack of preparedness, inconsistent follow-up, self-management skills, communication gaps, patient and family anxiety, as well as insurance challenges.
- Barriers to transition led to the creation of a grass roots diabetes transition program at Nemours under Dr. Mortensen, called the BUILT (Building Up Independent Lives for Teens) Curriculum recommendations:
- The program targets patients 15 years +
- The PDSA framework was used to guide the program
- Addresses financial and insurance barriers
- Strengthens patient education and self-management
- 8 steps of Program Development and changes that were implemented after participant feedback.
- Therapy dogs have been included in medical visits with great success.
- Data showing improvements in READDY, Navigation, Diabetes Management, and Insulin Management scores for their first ten graduates were shared. This data shows that implementing structured, patient-centered approaches can improve transition outcomes.
- Health Care Transitions Work Group working to leverage billable visits to pay for the program. Future plans: follow up with graduates as they move to an adult center.
- T1D Exchange Annual Survey Presentation, Dhruvi Vora, BS
- Overview of the 2024 Annual Survey results, conducted Sept to Nov, distributed to 62 centers. 18 Adult and 38 Pediatric centers responded.
- The survey included 48 questions split into six sections. Data from each section was shared and key points were discussed regarding:
- Center demographics
- Staffing
- Diabetes discharge
- Diabetes distress
- Screening and monitoring
- Best practice advisory
- Schools
- The next survey will be released in June, if you would like to propose questions to be added to the Annual Survey, please email QI@t1dexchange.org before 5/2/25 for consideration. We accept 4-8 questions on a thematic area (for example diabetes discharge, diabetes distress, etc.)
- T1D Exchange Hybrid Closed Loop Working Group, Carol Levy, MD, Mount Sinai (Adult) and Emily Coppedge, CPNP, CDCES, Weill Cornell (Pediatrics)
- Dr. Levy discussed the “rebranding” and shared the goals for the HCL Working Group in 2025.
- Aim 1: Facilitating discussion on use of hybrid closed loop systems
- Aim 2: Provide and share education tools and innovative ideas
- Five goals for the group were shared:
- Encourage knowledge sharing via monthly meetings and among participants
- Facilitate discussions on HCLs in diverse populations, including off-label and high-risk groups.
- Members to start QI projects based on discussions
- Explore publishing opportunities
- Increase participation. Membership is open to the entire Collaborative, all practice members, trainees, and fellows.
- Topics of meetings that have occurred this year, future topics, and upcoming presentations were provided.
- Dr. Levy discussed the “rebranding” and shared the goals for the HCL Working Group in 2025.
Next meeting: Adult Collaborative Call Tuesday July 22nd 3:30-5pm EST
Pediatric Collaborative Call Thursday, July 24th 11-12:30pm EST
Link to Recording:
Passcode: ?zkww9A*
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