Author Block: TREVON WRIGHT, LAUREN E. CULBRETH, NICOLE RIOLES, ALEXANDER TUTTLE, SHIDEH MAJIDI, SARAH LYDIA HOLLY, DANIEL J. DESALVO, LAURA LEVIN, CARLA DEMETERCO-BERGGREN, LAURA JACOBSEN, Boston, MA, Houston, TX, Indianapolis, IN, Washington, DC, Chicago, IL, San Diego, CA, Gainesville, FL
Introduction and Objective: Early identification of Stage 1 and 2 T1D enables timely therapy and monitoring to reduce DKA risk, yet routine screening is inconsistent across clinical settings. The T1D Exchange Quality Improvement Collaborative (T1DX-QI) launched a multicenter initiative to increase screening rates by 15% and monitoring by 30% from baseline over an 18-month period.
Methods: Four pediatric centers used QI tools, including process mapping, fishbone diagrams, and PDSA cycles, to address barriers and implement interventions focused on family education, workflow optimization, and provider engagement. Centers reported monthly data on screening volumes, autoantibody status, T1D staging, and interventions (monitoring and/or teplizumab).
Results: The 15% screening goal was exceeded by mid-2024, with sustained growth peaking mid-2025. Across centers, 596 screenings identified 194 autoantibody-positive individuals; 48 met Stage 1 and 49 Stage 2 criteria. Monitoring was offered to 101 patients, and teplizumab to 46. No DKA occurred.
Conclusion: This multicenter QI initiative demonstrates that structured QI strategies can successfully operationalize early-stage T1D screening. Combining family education with workflow optimization supports sustainable improvements in early detection.
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