Rioles, N, Mungmode, A, Odugbesan, O, Wright, T, Pasupneti, T, Garg, R, Haft, H, Gangupantula, G, Ebekozien, O

Background: Primary healthcare centers (PHCs) caring for people with diabetes are often overwhelmed and burdened by operational challenges and low resources. The aim of this study was to increase the capacity for PHCs to implement evidence-based quality improvement (QI) projects.

Methods: American Diabetes Association (ADA) recruited four PHCs into this project. T1D Exchange coached PHC from August 2023 – March 2024 on QI and change management. The PHCs selected QI metrics for the pilot phase; increasing HbA1c testing, kidney health screening, and statin prescribing for people with type 2 diabetes (PwT2D). PHCs identified barriers and tested improvement changes through Plan-Do-Study-Act cycles; PCPs reported aggregate monthly data for almost 8,000 people with type 2 diabetes.

Results: Three of the four participating centers completed the pilot phase. Demonstrating overall improvement in QI capacity, all centers improved in at least one clinical outcome measure. One of the centers improved statin prescribing by 7% (Fig.1). A1c screenings increased by 14%.

Conclusion: Common challenges observed across PHCs include fewer staff with dedicated time for QI, data reporting challenges, limited QI resources, constraints implementing workflow change, and lack of dedicated QI leadership. Providing external assistance through QI coaching and support can improve capacity to make robust practice transformation. Fig. 1

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