Introduction: The T1DX-QI is a national Type 1 diabetes learning health system with thirteen endocrinology centers. The program is coordinated by the T1D Exchange in Boston, Massachusetts.

Many studies that has demonstrated the clinical benefit of Continuous Glucose Monitors (CGM) and sensors. Although favorable insurance policy changes have gradually increased the adoption of CGM devices nationally, widespread uptake has been slow.

Objective: This abstract describes how ten clinics in the T1DX-QI used QI principles including the Model for improvement including Plan – Do – Study – Act (PDSA) cycles to test and expand different initiatives in their respective centers across the United States. The interventions that were tested include the redesign of relevant workflows, assessed and removed barriers to adoption, expanding CGM educational programs.

Methods: The centers tested and reported the results of the interventions for patients in the 12–26 age cohort. The coordinating center (T1D Exchange) used Quality Improvement control and run charts rules to evaluate the effectiveness of the interventions (Figure 1 – Collaborative Wide Improvement Run Chart).

Results: Eight of ten participating centers improved their CGM uptake significantly. The increase ranged from 7% – 34%, three sites were able to improve their CGM uptake by more than 20% from baseline over the duration of the project. There was a 12% significant improvement from baseline in 20 months across the entire cohort of centers. Over 900 patients in the 12–26 years cohort were directly positively impacted by this project.

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