Slide Deck

Coordinating Center Updates

Presenters: Nicole Rioles, MA; Ori Odugbesan, MD, MPH; Alyssa Cabrera, MPH

  • Abstract Submissions
    • T1DX submitted 14 abstracts to ADA
    • In additional 5 late-breaking abstracts will be submitted
  • 2026 Annual Survey Questions
    • Proposals due May 1
Learning Session abstracts will be published next month in the Journal of Diabetes
  • Learning Session presentations and posters are available on the member website:
https://t1dx-qi.t1dexchange.org/2025-learning-session/
  • New SmartSheets for the measurement period will be shared with teams within the next month
  • Alyssa Cabrera shared an overview of the 2026–2028 pediatric metrics
  • Discussion addressed the use of GMI as a valuable metric when HbA1c cannot be obtained:
    • GMI should be interpreted in context
    • Further discussion would be better suited for an offline conversation or a future Learning Session

Screening and Monitoring Update

  • Overview of the Beta Cell Preservation Work Group
  • A white paper has been developed and will be available for dissemination by February 23 on the T1D Exchange website

Center Presentation: Rainbow Babies and Children’s, University Hospitals

Presenter: Anna Neyman, MD

Topic: Depression Screening QI Project

  • Mental health is an important component of both well-being and glycemic control
  • Aim: Increase depression screening among eligible youth with T1D from 50.9% to >70% within 6 months
  • Interventions
    • Education
    • EMR: Creation of a Diabetes Tab and collaboration with the Epic team to optimize workflow
  • Epic dot phrase to automatically pull screening results and corresponding plans based on score
  • Methods to Assess Interventions
    • Review of three clinic days per month
    • PDSA cycles
  • Results
    • Initial decreases in screening rates prompted further analysis and additional interventions
    • Most recent monthly average screening rate is 90%
  • Next Steps
    • Project has transitioned to the maintenance phase
    • Assess post-intervention outcomes

Topic: AID QI Project – Improve Utilization of AID Technology

  • Primary Aim: Increase the proportion of patients achieving glycemic targets in an equitable manner
    • Increase AID utilization by at least 5% within 12 months
  • First PDSA cycle is underway
  • Fishbone analysis identified barriers to AID utilization

Center Presentation: Seattle Children’s Hospital

Presenter: Jessica Johnson, ARNP

Topic: Utilizing Quality Improvement to Implement and Standardize Peripheral Neuropathy Screening in Pediatric Patients with Diabetes

  • ADA Standards of Care: Foot exams for youth with T2D at diagnosis and annually thereafter
  • DFE: Diabetic Foot Exams
  • Identified care gaps and lack of supplies for DFE
  • No standardized method for tracking DFE completion or complications
  • Aim: Increase annual diabetic peripheral neuropathy screening for eligible youth with T2D to 20% by 12/31/2025
  • Interventions
    • Supply kit (implemented at project start)
    • Infographic (implemented at project start)
    • Michigan Neuropathy Screening Instrument (MNSI) questionnaire (implemented at project start)
      • A score of ≥7 indicates a positive screening
    • MNSI exam (implemented at project start with modifications as tests of change)
      • A score of >2 indicates a positive exam
    • Educational materials (implemented at project start with modifications as tests of change):
      • Tips for Healthy Feet
      • Diabetes Foot Care Tips
  • Questionnaire Findings
    • Identified teaching opportunities for providers to differentiate normal from neuropathic symptoms
  • Conclusions
    • Low-cost interventions embedded into usual workflow
  • Lessons learned:
    • Staff education was a key driver of QI success
    • Low-cost changes can meaningfully improve diabetes care
    • Epic tools supported standardization of documentation
  • Next Steps
    • Clinic-wide scaling and staff training
    • Addition of DFE supplies to recurring inventory and optimization of the EHR
    • Ongoing process improvement