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.


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.

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