Background: Insulin pump therapy is associated with enhanced quality of life (QoL) and lower HbA1c levels in youth with T1D. At our institution, we noted underutilization of insulin pumps and variability in prescribing practices. Thus, we led a quality improvement initiative to increase insulin pump use in youth age <18 years with new-onset T1D (duration <1 year) from baseline of 17% to >25% from January 2021 to November 2022.
Methods: A series of Plan-Do-Study-Act cycles began at one of our three campuses with spread to all locations, including education of diabetes educators and providers about a newly created pump initiation algorithm with action plan for sick day management, standardized prescribing recommendations with intent to mitigate prescribing biases, early introduction of pumps by 90 days from diagnosis, and advanced scheduling of post-pump follow ups.
Results: P-Chart (Figure 1) shows an increase in percentage of patients with new onset T1D on insulin pump therapy from a process average of 17% to 21%.
Conclusion: Our QI efforts on standardizing the approach to pump therapy initiation and multidisciplinary education led to an increase in insulin pump uptake in our new-onset T1D cohort. We plan to evaluate improvement in HbA1c levels, pump related hospitalization rates, and impact on QoL in our patient cohort.
M.Vakharia: None. D.A.Buckingham: None. S.Lyons: None. D.Desalvo: Consultant; Dexcom, Inc., Research Support; Insulet Corporation. R.Y.Sonabend: None. G.K.Kim: None.
