Introduction Approximately 6% of pregnant women develop gestational diabetes mellitus (GDM), which is a strong risk factor for developing type 2 diabetes mellitus. It is recommended that women with GDM complete a 75‐g oral glucose tolerance test (OGTT) 4 to 12 weeks postpartum to screen for type 2 diabetes. A 3‐month retrospective chart review in 2 patient‐centered medical homes found that postpartum screening for type 2 diabetes was performed in only 39% of eligible women, despite recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the American Diabetes Association. Thus, a quality improvement project was initiated to improve the postpartum type 2 diabetes screening rate. Process This quality improvement project involved an education session that described current ACOG recommendations for diabetes screening. The education session included a pretest and posttest that evaluated participants’ understanding about development of type 2 diabetes after GDM. A team‐based postpartum guideline designed to enable women to complete a 75‐g OGTT at the 4‐to‐12‐week postpartum appointment was implemented. A postintervention chart review was conducted to determine the postintervention rate of type 2 diabetes screening. Outcome The mean pretest score for the clinical team was 57%, and the mean posttest score was 99%. Postpartum screening for women with GDM was improved from 39% of women for whom screening was indicated to 77% with the implementation of the team‐based guideline. Discussion The quality improvement project results demonstrated that improved understanding of ACOG recommendations combined with the implementation of a team‐based guideline significantly improved postpartum screening for type 2 diabetes. Team‐based management of care, including education of team members about the rationale for change, may also improve outcomes in other quality improvement projects.

INTRODUCTION: Postpartum testing of gestational diabetes (GDM) patients with an oral 2-hour glucose tolerance test (OGTT) is suboptimal, with national rates ranging from 18-57%. The purpose of this study was to investigate if a standardized workflow supplemented with educational sessions could improve the OGTT screening rate. METHODS: A multi-disciplinary workflow was implemented in two Medicaid clinics in January 2018. Pre-intervention subjects were GDM patients in the 4-12 week postpartum period between March-June 2017, while post-intervention subjects were between January-April 2018. Immediately prior and during the post-intervention time period, the obstetrical team received small-group education sessions on the American College of Obstetricians and Gynecologists (ACOG) GDM guidelines, with re-enforcement of workflow. A pretest and posttest were performed to assess effectiveness. Paired t-test was used to compare the pretest and posttest scores, and chi-square testing was used to compare compliance with screening. IRB approval was obtained for this study. RESULTS: Nineteen out of thirty members (63%) of the obstetric team completed the educational session. Mean pretest score for the team was 57.4%; the mean posttest score was 99.2% (p<0.01). Eighteen patients were in the pre-intervention group, while 26 patients were in the post-intervention group. Postpartum screening of GDM patients improved from 39% to 77% after workflow implementation (p=0.01). CONCLUSION: Educational sessions and standardized workflow interventions utilizing a multi-disciplinary team were associated with improvement in both understanding of the ACOG guidelines and patient compliance with postpartum glucose screening. This team-based approach may be useful in other quality improvement initiatives.