Objective: Performance in providing optimal type 1 diabetes care has historically focused on only one metric, HbA1c. Our objectives were to design and test a metric that evaluated overall quality of care and to use this metric to drive improvement within our diabetes program.

Methods: The Type 1 Diabetes Care Index (T1DCI) aggregates missed opportunities for best practices into a composite score that reflects overall program performance. Elements of optimal care that should be reliably delivered were compiled into 14 domains over three areas: (1) Delivery of patient care, (2) Preventative Screening, (3) Psychosocial support. The T1DCI is the aggregate number of missed opportunities to provide quality care over a given time period. A lower T1DCI reflects better care and overall improved system performance.

Results: The T1DCI was easy to calculate and implement, and was well accepted by our diabetes team. The annual T1DCI progressively decreased from 5,338 at baseline to 3,821 after 10 months of utilization, a 14% reduction. Improvements in care were realized across some index domains and areas for focusing improvement efforts were recognized in others. New initiatives to provide optimal care were created.

Conclusions: The T1DCI is a useful metric to evaluate the ability of our program to deliver optimal care, and to document performance improvement across a broad range of domains.


K. Obrynba: Consultant; Self; Dexcom, Inc. J.A. Indyk: None. K. Gandhi: None. D.A. Buckingham: None. A.M. Kramer: None. K. Hong: None. B. Glick: None. T. Wells: None. T.C. Barnard-Kirk: None. M.L. Smith: None. A.M. Moffett: None. M.K. Kamboj: None.

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