Quality Improvement in Diabetes Care: Time for Us to Step Up?

Abstract

Canadian Journal of Diabetes j o u r n a l h o m e p a g e : w w w. c a n a d ia n j o u r n a l o f d i a b e t e s. c o m

Ten years of improving glycemic control in pediatric diabetes care: Data from the Norwegian Childhood Diabetes Registry

“…Our results support this benefit, consistent with several other studies on the effect of quality improvement projects (18,(36)(37)(38). Such quality improvement work may, in addition to improving patient care and glycemic outcomes, reduce frustration and inertia among patients and health care professionals "from care processes that just do not work" (17), thus having an effect over a longer period. However, maintaining quality improvement after a project period has ended is commonly described as "the trickiest part of any [quality improvement] project" (39), yet the HbA 1c results during the 4 years following the project in our study show that sustained effects from quality improvement work are possible.…”

“…HbA 1c values, while others have reported increases in recent years (8). Differences in the achievement of the 53 mmol/mol (7.0%) HbA 1c target in different populations have been attributed to variations in national HbA 1c targets (5,9), differences in the use of diabetes technology (10)(11)(12)(13)(14)(15), quality improvement projects (16)(17)(18)(19)(20)(21), and carbohydrate counting for meal bolus calculation (21)(22)(23). Sweden has drawn international attention by consistently reducing its national mean HbA 1c over many years in the pediatric age-group through quality improvement collaborations.…”

Ten Years of Improving Glycemic Control in Pediatric Diabetes Care: Data From the Norwegian Childhood Diabetes Registry

“…Our results support this benefit, consistent with several other studies on the effect of quality improvement projects ( 18 , 36–38 ). Such quality improvement work may, in addition to improving patient care and glycemic outcomes, reduce frustration and inertia among patients and health care professionals “from care processes that just do not work” ( 17 ), thus having an effect over a longer period. However, maintaining quality improvement after a project period has ended is commonly described as “the trickiest part of any [quality improvement] project” ( 39 ), yet the HbA 1c results during the 4 years following the project in our study show that sustained effects from quality improvement work are possible.…”

Equitable Post-COVID-19 Care: A Practical Framework to Integrate Health Equity in Diabetes Management

“…Traditional QI programs might use a process map or flow diagram to depict the current state of a process visually. 16 For example, in Figure 1, the process map diagram depicts some differences in the process for patients with public insurance as opposed to those with private insurance. The framework also advocates for using visual tools like process maps to depict how there might be inequitable pathways in a system.…”

“…A good understanding of factors that contribute to the problem is an essential part of finding fundamental solutions. The fishbone diagram 16 is a visualization tool used to identify contributing factors. When investigating contributing factors, it is commonplace to identify factors that fit into 1 of 5 categories: people, process, place, product, and policies (5 Ps).…”