Due to the COVID-19 pandemic, our endocrinology clinic transitioned to virtual care on March 18, 2020. The literature suggests that self-monitoring of blood glucose paired with telemedicine consultations is an effective strategy for diabetes management, however it is unclear whether telemedicine remains effective in the context of the sudden lifestyle changes caused by the pandemic, including non-essential service closures, travel restrictions, lockdowns, and psychosocial impacts. Patients with diabetes are uniquely affected by these restrictions, as glycemic control is heavily dependent on lifestyle and access to essential medications and supplies. The purpose of this project is to determine the impact of telemedicine consultations in the context of the COVID-19 pandemic on the glycemic control of patients seen at our clinic. A retrospective chart review was performed on 300 type 1 and 2 diabetes patients seen at least once within the 6 months preceding (pre-COVID) and following (post-COVID) March 18, 2020. The primary outcome measure was hemoglobin A1c. For patients with more than 1 A1c value in each time frame, the most recent A1c was used. Demographic information was also collected. There was no significant difference in the pre-COVID and post-COVID A1c values (p=0.40) of the entire sample. There was no significant difference in the pre-COVID and post-COVID A1c values when the sample was stratified by age, diabetes duration, use of CGM, or use of pump. However, there was a significant increase in A1c for females post-COVID (p<0.05). This difference was not observed for males (p=0.22). Our data suggests that telemedicine is an overall effective strategy for optimizing glycemic control of patients with type 1 and type 2 diabetes during the pandemic, with no significant difference in A1c. However, the gender-specific effect of telemedicine consultations during COVID-19 on the glycemic control of females with diabetes indicates a need for further study and intervention. Disclosure A. Dissanayake: None. M. Pawlowska: Advisory Panel; Self; Novo Nordisk. B. Schroeder: Advisory Panel; Self; AstraZeneca, Novartis Pharmaceuticals Canada Inc. J. Mackenzie-feder: None. A. White: Advisory Panel; Self; Abbott Diabetes, AstraZeneca, Boehringer Ingelheim (Canada) Ltd., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk Canada Inc.

Introduction: Hand hygiene is critical in preventing the spread of healthcare-associated infections. Routine hand hygiene surveillance and education are common for clinical staff in pediatric acute care settings. However, nonclinical staff, including research personnel, are often excluded from these programs and therefore represent a gap in ongoing infection control efforts. This project aimed to evaluate the impact of evidence-based interventions on improving hand hygiene adherence among research personnel in the pediatric emergency department to meet provincial targets set for clinical staff. Methods: We used a Plan-Do-Study-Act approach to carry out a peer-driven, multimodal hand hygiene improvement strategy involving education, surveillance, and feedback targeted to research assistants working in a pediatric emergency department. Two anonymous peer evaluators observed hand hygiene practices in several specific instances (eg, before/after patient interactions) and determined adherence a priori. Results: In an open sample of clinical research assistants (N total = 22), hand hygiene adherence increased from 12.5% to 89.1% over 11 months. Increases in adherence were particularly notable before entering the patient environment compared to exiting. Conclusions: Hand hygiene interventions targeting research personnel show potential success in acute care. Further quality improvement initiatives in larger research personnel samples must robustly evaluate the framework's effectiveness.

Hybrid closed-loop (HCL) insulin pump therapy is a promising development for the management of type 1 diabetes (T1D), but little is known about the transition period to HCL in a real-world setting. Here, we present novel data evaluating the HCL transition experience and its effect on diabetes distress. We evaluated 32 out of 150 anticipated participants who were about to transition (Arm A), or had recently transitioned (Arm B), from standard pump therapy to the MiniMed™ 670G HCL pump. Patients completed a baseline and 6-month post-transition diabetes distress survey using the T1-DDS. In the follow-up survey, patients’ trust in HCL and treatment satisfaction were also assessed. Finally, post-survey interviews were conducted for patients to elaborate on the successes and struggles of their HCL transition experience. No significant differences were observed between the 2 arms, so the sample was analyzed as a whole. After 6 months on HCL, significant reductions were observed in overall diabetes distress (p<0.0001), as well as powerlessness (p<0.005), management (p<0.001), hypoglycemia (p<0.005), and eating (p<0.0005) distress. Most patients (56%) indicated difficulty trusting HCL, however 80% reported that trust improved over time. Patient satisfaction was high (81%), however only 47% indicated that HCL met their expectations, 56% would recommend HCL to others, and 66% indicated frustration with the transition to HCL. Patients were divided on whether HCL increased (41%) or decreased (47%) the workload required to manage their T1D (12% neutral). Over half of patients (59%) felt that HCL was too complicated. Patients were divided on whether HCL was too much of a “hassle” to use (31% yes, 38% no, 31% neutral). Emerging themes from the qualitative data include numerous alarms, loss of sleep, and necessity of “phantom carbing.” Overall, HCL therapy significantly reduces diabetes distress, but the patient transition experience is varied in terms of trust, satisfaction, and comfort with the technology. Disclosure A. Dissanayake: None. E. Chow: None. A. White: Advisory Panel; Self; Abbott Diabetes, AstraZeneca, Boehringer Ingelheim (Canada) Ltd., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk Canada Inc. J. E. Kapeluto: None. J. Mackenzie-feder: None. B. Schroeder: Advisory Panel; Self; AstraZeneca, Novartis Pharmaceuticals Canada Inc. M. Pawlowska: Advisory Panel; Self; Novo Nordisk.

The COVID-pandemic has required changes to healthcare delivery and has been a stressful time for people with diabetes mellitus (DM) . Previous literature suggests that virtual health appointments for diabetes care can be effective and result in high patient satisfaction. However, it is unclear if patients with DM are satisfied with the widespread adoption of virtual care during the pandemic. The aim of this study was to evaluate the impact of virtual care during the pandemic on patient satisfaction in patients with type 1 and type 2 DM. The validated Patient Satisfaction Questionnaire (PSQ-III) was completed by 197 patients who had an in-person appointment in the six months before March 18, 2020 (pre-COVID) and a subsequent virtual appointment within six months after that date. For each form of healthcare delivery (i.e. in-person and virtual) , the satisfaction in six aspects of care was measured: general satisfaction, technical quality, interpersonal manner, communication, time spent with doctor, and accessibility of care. Both type 2 DM and age >55 years were associated with decreased general satisfaction with virtual care compared to in-person care. Both type 2 DM and female sex were associated with decreased technical quality of care. Accessibility of care decreased significantly in the overall study group. No significant differences in patient satisfaction were observed in the type 1 DM group. Despite our findings, 74% of respondents answered they would consider virtual health appointments in the future. Our data suggests that many patients welcome virtual health as an addition to their medical care. However, virtual health does not seem to deliver the same level of patient satisfaction as in-person appointments over the longer term. Future research on how fatigue with pandemic restrictions has affected patient satisfaction is needed to evaluate whether virtual health appointments are a viable option for long term diabetes care. Disclosure C.Chang: None. A.Dissanayake: None. M.Pawlowska: Advisory Panel; Novo Nordisk, Other Relationship; Medtronic. B.Schroeder: Advisory Panel; Novartis Canada, Novartis Canada, Novartis Canada, Novo Nordisk Canada Inc., Novo Nordisk Canada Inc., Novo Nordisk Canada Inc. J.Mackenzie-feder: Advisory Panel; Recordati S.p.A. A.White: Advisory Panel; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, HLS Therapeutics Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Canada Inc.

No abstract