T1DX-QI Pediatric Collaborative Call

Participants: Tim Bol, Claire Rainey, Alyssa Cabrera, Don Buckingham, Stephanie Ogburn, Katie Pittz, Claire Kim, Christy Byer-Mendoza, Siham Accacha, Rachael Mullin, Jennifer Sherr, Risa Wolf, Jessica Schmitt, Ines Guttman-Bauman, Neha Parimi, Amy Poetker, Saketh Rompcherla, Donna Eng, Kelli Holland-Goree, Adriana S., Hope Zamora, Kim Rossi, Laura Jacobsen, M. Tracy Bekx, Andrea Huber, Harshini Pyata, Grace Kim, Priya Prahalad, Rachael Lee, Janey Bootle, Abha Choudhary, Lydia Holly, Vana Raman, Jacob Redel, Andrea Mucci, Joseph Erardi, Whitney Beaton, Naomi Fogel, Andrew Lavik, Lily Chao Dhruvi Vora, Allison Smego, Elizabeth Brown, Lori Benzon, Preneet Cheema Brar, Mindy Lee, Melissa Mink, Meenal Gupta, Jeniece Ilkowitz, Alyssa Rowe, Justin Indyk, Candice Williams, Andrea Mucci, Rona Sonabend, Ibrombe1, Anna, Taylor Stephens, Roberto Izquierdo, Milki Vakhara, Andrea Mucci, Yllka Valdez, Neha Vyas, Luke Cielonko, Edith Fiore, Roberto Alcazar Dipalma, Malak Abdel-Hadi, David Maas, Katie Craft, Alissa Roberts, Brian Miyazaki, Adriana Saldana, Anna Meyman, Siri Poom, Jennifer Jespersen, Rachel Lee

 

July 23rd, 2026 11:00am to 12:30pm EST

July Pediatric Call Slides

Meeting Recording

Passcode: !bdPPY8V

Meeting Agenda:

Updates from the Coordinating Center:

Center Presentations:

  • Johns Hopkins University
  • Stanford Medicine

2027 Meeting Schedule

  • Outlook invitations will be sent by 8/15 to help you plan your 2027 calendar.
  • Schedule will also be updated on the member website.
  • 2027 Meeting Schedule.pdf

Learning Session Reminders

Annual Survey release date: 8/17/2026

  • The annual survey will go live August 17
  • Survey information will be emailed to center PIs and coordinators
  • One survey should be completed by each center by October 1st
  • Thank you for your contributions!

Office Hours with Dr. Wong

  • Please use the Zoom links below to join office hours:
    • First Thursdays 9-11am PT (12-2pm ET) - starting July 2: Zoom Link
    • Third Tuesdays 1-3pm PT (4-6 pm ET) - starting June 16: Zoom Link

QI Portal Updates

Center Presentations:

Reducing Hospital Readmissions in Youth with High Risk of DKA

Neha Parimi, MBBS, MPH, Johns Hopkins Medicine

  • Dr. Parimi reviewed how Johns Hopkins Medicine's diabetes center previously maintained lists which led to miscommunication and missed appointments due to inefficient processes and communication.
  • JHU developed an aim to reduce DKA admissions by 15%.
    • Worked with Texas Children’s to create a dashboard for all patients who were admitted in DKA.
    • Provided a wraparound program for patients admitted in DKA and incorporated it into their Epic build.
  • This DKA dashboard was coupled with an automated risk score to provide an accurate and efficient solution for the care team to identify highest-risk patients.
    • QI tools such as a Key Driver Diagram and Fishbone were shared.
    • A multidisciplinary approach was used for protocol development.
    • Contacting high-risk people would alternate between nurses and social workers on the care team, to maximize touch points with the patients.
    • Gift cards were provided for patients enrolled in the cohort.
  • Discussion occurred about how to keep people in this high-risk cohort from readmitting with DKA, next steps for the program, how to proactively outreach patients, achieve higher engagement, and perhaps including an “opt-in” policy.
  • Additional discussion occurred about staffing and the resources required to make this program sustainable with suggestions from the group for AI integration.

 

β-Cell Preservation Therapy Workflows at Stanford Medicine Children’s Health for Stage 2 and Stage 3 T1D

Priya Prahalad, MD, PhD, Stanford Medicine

  • Dr. Prahalad shared key objectives and drivers for beta cell preservation therapies and reviewed the FDA approval guidelines for Teplizumab Stage 2.
  • Protocols cover both Stage 2 (pre-clinical) and Stage 3 (new-onset T1D within 8 weeks) using Tzield (teplizumab), alongside alternatives like verapamil and clinical trials (e.g., TrialNet).
  • Stage 2 Teplizumab clinical workflows and screening protocols were shared:
    • There is no formal screening program in place
    • Infusion Protocol: 5-day dose ramp-up with required premedications; remaining days optional.
  • Stage 3 (New Onset) Workflows were also shared:
    • Modified new-onset order sets to automatically capture C-peptide and antibodies (via biobanking or clinical labs). Re-testing used if initial C-peptide is suppressed due to DKA.
  • Logistics and Operational Framework:
    • Coordinating 14 consecutive days of infusions is challenging
    • Current Setup: Monday–Saturday infusions occur in the Short Stay Unit (SSU); Sunday visits are handled via hospital outpatient observation.
    • Crucial patient and family education is established in a bi-weekly Bet Cell Preservation Class and plain-language handouts illustrating realistic outcomes.
  • Cross-functional Team Collaboration:
    • Close coordination between pediatric endocrinology, SSU schedulers, pharmacy, hospitalists, and financial counselors, as this process is costly.
  • Alternative and Adjunct Therapies:
    • Verapamil (not FDA approved) and clinical trials were discussed.
  • Discussion occurred about Stanford’s experience with Verapamil, consideration for home infusions, and how thankful the group was for Dr. Prahalad presenting on this topic as there is a lot of excitement for other centers to do this work.
  • Additional discussion occurred about how to council families and deal with the information overload from new onset information and deciding on this rigorous process.