Christy Byer-Mendoza, MSN, RN, CNS, CPN is a pediatric diabetes nurse educator at Rady Children’s Hospital-San Diego. Byer-Mendoza received her Master of Science in Nursing Degree from Point Loma Nazarene University in San Diego, California. Over the past five years, she’s focused primarily on quality improvement projects, improving the delivery and precision of diabetes care.   

Byer-Mendoza and the clinical diabetes team at Rady have been engaged with the T1DX-QI since 2020, improving the quality of care and patient outcomes through the implementation of effective processes and system advancements. 

Interview with Christy Byer-Mendoza, MSN, RN, CNS, CPN  

In this interview, Byer-Mendoza discusses her expertise in supporting people with type 1 diabetes (T1D) and working to improve patient care through the T1D Exchange Quality Improvement Collaborative (T1DX-QI).

The T1DX-QI was established in 2016 — with the support of The Leona M. and Harry B. Helmsley Charitable Trust — in an effort to refine best practices and improve daily life for people with type 1 diabetes (T1D). Growth has been tremendous, with 54 endocrine clinics from across the U.S. participating in the Collaborative. 

Fueled by top leaders in diabetes care, the T1DX-QI has become an engine of innovation and inspiration. By engaging with the shared, data-driven, and systematic methods of the T1DX-QI, clinics have seen unprecedented success in their approach to diabetes management.   

With members working closely together to identify gaps in care, discover and refine best practices, and share research — the process has become knowledge-sharing at its very best. While collated data gives clinics a clear sense of “where they are,” it also demonstrates “where they can be” by applying shared, evidence-based methods for improving care.

What led you to diabetes care? 

Byer-Mendoza, who has been a diabetes nurse educator since 2018, began her medical career at Rady in 2005 as an inpatient night nurse. When she was approached about shifting into the diabetes clinic lead position, it was a natural progression of sorts. 

“In my previous role, I was a bedside nurse caring for kids with newly diagnosed T1D or those re-admitted with acute issues — such as DKA,” explained Byer-Mendoza, who also served as a nurse educator on her unit training nurses on best practices and standards of care with evidence-based research.  

“Switching from nursing education with my peers to a focus on patient outcomes, quality improvement, and direct patient care has been an incredibly satisfying career shift,” said Byer-Mendoza. 

What do you enjoy most about your work? 

“The patients,” Byer-Mendoza responded without hesitation. “Not only do I get to witness a child’s progression with diabetes, but I’m also able to watch them grow and mature. Getting to know my patients as individuals — understanding what’s going on in their lives, how they learn best, and what their stressors are helps me to adapt and provide the best care possible,” said Byer-Mendoza.  

“I really have a passion for education and enjoy patient-focused work — which may be teaching a patient and their family about diabetes tech, seeing them for follow-up appointments, participating in our Teen Rock group, or having fun at Camp Wana Kura. Developing long-lasting, trusting relationships with patients results in seamless diabetes care.” 

Rady Children’s Hospital-San Diego and T1DX-QI 

“In March of 2020, the week before the pandemic shut us all down, we participated in our first T1DX-QI Learning Sessions and took it running from there,” said Byer-Mendoza, whose QI team consisting of Dr. Demetereco, who serves as the lead PI, Dr. Cymbaluk, Kim McNamara, and Andrea Hubner, went on to receive the “T1DX-QI Outstanding New Team Award” in 2020 for their extraordinary contributions in their first year of participation. 

“What I love most is collaborating with other T1DX-QI centers and sharing best practices. We follow the mantra, ‘Share seamlessly and steal shamelessly,’ said Byer-Mendoza.  

“At our first T1DX-QI Learning Sessions, Rady Children’s didn’t have a CGM policy in place. But rather than starting from scratch, we connected with another clinic that did — and because of this, we were able to institute a CGM policy by October of 2020.” 

“T1DX-QI meetings are the ones I don’t want to miss. I really enjoy collaborating with other members as well as attending in-person events,” said Byer-Mendoza who joked, “I’m the annoying person asking, ‘Can we have more meetings?’” 

Quality improvements at Rady Children’s Hospital-San Diego 

“We have quite a few projects that we’ve been working on as a group,” explained Byer-Mendoza. “We’re currently part of the second T1DX-QI Equity Program cohort, and we’re looking at our processes for CGMs, pumps, and InPens.”  

By tackling these issues head-on with an equity lens, Byer-Mendoza believes that tech disparities can be addressed more fully, resulting in program improvements.  

“In our T1DX-QI equity training one thing that hit home for me is ‘one size doesn’t fit all’,” said Byer-Mendoza. “We know the outcomes we’re looking to achieve, and we’re diligently trying to get there, but we can’t without taking the population we’re serving into account.” 

At present, one of the biggest equity challenges at Rady Children’s Diabetes Clinic is providing education in Spanish. “Having in-person interpreters during learning sessions is so important. People need to look and feel — and have the ability to ask questions on the spot.”  

While a recent attempt to run a Spanish-speaking focus group came up short, Byer-Mendoza is certain that by examining disparities, they can get a clearer sense of what the underlying issues are.  

What’s next? 

“Again, our biggest push is with our equity work,” said Byer-Mendoza. “At Rady Children’s, we’re also set to become involved in T2D inclusion work with T1DX-QI, as well as a project with Teplizumab to delay the onset of T1D.” 

“We’re still working on increased rates of pump use, and our team is focused on increasing patient use of our Glooko interface, for data extraction to analyze time-in-range, as we’re completely mapped with the T1DX-QI.” 

What do you enjoy outside of work?  

“A lot of things,” laughed Byer-Mendoza. She is a lifetime Padres fan, outdoorswoman, and yoga instructor who loves paddle boarding, hiking, traveling, and spending time with family and friends.