Quality Improvement in Diabetes Care: A Review of Initiatives and Outcomes in the T1D Exchange Quality Improvement Collaborative

Abstract

Despite immense strides in therapeutic advances, clinical outcomes continue to be less than ideal for people with type 1 diabetes. This discrepancy has prompted an outpouring of quality improvement (QI) initiatives to address the medical, psychosocial, and health equity challenges that complicate ideal type 1 diabetes care and outcomes. This article reviews a framework for QI in diabetes care that guided the development of the T1D Exchange Quality Improvement Collaborative to improve care delivery and health outcomes in type 1 diabetes. Evaluation of the methodology, outcomes, and knowledge gained from these initiatives will highlight the importance of continued QI initiatives in diabetes care.

Addressing type 1 diabetes health inequities in the United States: Approaches from the T1D Exchange QI Collaborative

“…QI is a practical approach to test changes and sustain successful interventions 11,12 . Due to the thoughtful approach and emphasis on process changes, QI has extensive applicability to T1D management and can help address health inequities with suitable equity adaptations.…”

“…QI is a practical approach to test changes and sustain successful interventions. 11 , 12 Due to the thoughtful approach and emphasis on process changes, QI has extensive applicability to T1D management and can help address health inequities with suitable equity adaptations. In 2020, the T1DX‐QI developed an Equity Framework, 18 which is an adapted QI method designed to promote equity principles in QI interventions.…”

“… 8 T1DX‐QI is a learning health network 9 with over 40 centers across the United States. Participating centers use continuous quality improvement (QI) methods 10 , 11 , 12 and real‐world electronic medical record (EMR) data 4 , 6 for T1D population health improvement.…”

“…The T1DX‐QI has successfully used QI principles and implementation science to improve clinical processes, including increased use of continuous glucose monitors (CGM), insulin pumps, depression screening, improved access to care, and population‐level glycemic outcomes. 9 , 10 , 11 , 12 …”

T1D exchange quality improvement collaborative: Accelerating change through benchmarking and improvement science for people with type 1 diabetes

“…Quality improvement (QI) efforts have been shown to improve outcomes for patients with T1D. 2 The T1D Exchange Quality Improvement Collaborative (T1DX‐QI) was established in 2016 with 10 pilot centers, primarily consisting of pediatric sites. 3 , 4 The collaborative has now grown to 41 participating centers (28 pediatric and 13 adult centers) across the United States (Figure 1 ).…”