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Background: Continuous glucose monitors (CGMs) support patients with type 1 diabetes to maintain optimal glycemic targets and health outcomes. The T1D Exchange Quality Improvement Collaborative (T1DX-QI) is a network of over forty endocrinology centers working to improve health outcomes by implementing QI science. We aim to demonstrate the use of QI methodology in expanding CGM use across seven T1DX-QI clinics.
Method: Clinics initiated iterative plan-do-study-act cycles to test changes and sustain improvements. Interventions included patient education and involvement through print or electronic materials, device troubleshooting, and data downloads. Sites enhanced clinic processes by optimizing paperwork requirements for new devices and standardizing a referral process for patients who faced body image challenges. Clinics shared monthly aggregate data with T1D Exchange coordinating center.
Results: All participating clinics were successful in improving CGM use. Cumulatively, CGM use increased from 66% to 71% over 14 months (Figure 1) . Clinic-level improvement ranged from 5% to 18%, with an average improvement of 9%.
Conclusion: Efficiently implemented QI science can support teams to improve patient health outcomes, including meaningful device access to support glycemic control in patients with type 1 diabetes.
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