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1174-P: Reducing Lost to Follow-Up Rates in the T1D Exchange Quality Improvement Collaborative (T1DX-QI)

2020; American Diabetes Association; Volume: 69; Issue: Supplement_1 Linguagem: Inglês

10.2337/db20-1174-p

1939-327X

Ryan McDonough, Sarah Thomas, Nicole Rioles, Osagie Ebekozien, Mark A. Clements, Sarah Corathers, Joyce M. Lee, Ashley Garrity, Priya Prahalad, Manmohan K. Kamboj, Don Buckingham, G. Todd Alonso,

Diabetes Management and Education

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. Disclosure R. McDonough: None. S. Thomas: None. N. Rioles: None. O. Ebekozien: None. M.A. Clements: Consultant; Self; Glooko, Inc. Other Relationship; Self; Glooko, Inc. S. Corathers: None. J.M. Lee: Advisory Panel; Self; Goodrx. Consultant; Self; T1D Exchange. Research Support; Self; Lenovo. A. Garrity: None. P. Prahalad: None. M.K. Kamboj: Research Support; Self; Type 1 Diabetes TrialNet, Unitio, Inc. D.A. Buckingham: None. G.T. Alonso: None.