McDonough, R, Thomas, S, Rioles, N, Ebekozien, O, Clements, M, Corathers, S, Lee, J, Garrity, A, Prahalad, P, Kamboj, M, Buckingham, D, Alonso, T

The ADA recommends quarterly follow-up for routine diabetes care, however, this is not consistently achieved. This gap represents an opportunity to improve care. The T1D Exchange Quality Improvement Collaborative (T1DX-QI) aims to improve T1D care in the U.S. through structured sharing of best practices. To reduce the lost to follow-up (LTFU) rate, five pediatric centers identified key change concepts, designed iterative testing cycles, and used data visualization to inform future interventions. Patients <18 years were considered LTFU if their last visit was 180-365 days ago without a future visit scheduled. The following interventions were developed during monthly workgroup calls: establishing standard work, outreach between visits, offering patient portal self-scheduling, scheduling future visits at registration, scheduling multiple follow-ups, and improving adult care transition. Analysis included 14,790 patients across the five sites. Successful application of QI methodologies resulted in improvement across all ages. With a reduction to < 4%, 156 youth were proactively reengaged with diabetes care. Continued follow-up of this population will focus on identifying and overcoming barriers to LTFU and assess which interventions had the biggest impact. We are developing a “Change Package” with successful interventions to share with other diabetes centers.

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