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The diabetes care index: A novel metric to assess delivery of optimal type 1 diabetes care
Author(s) -
Obrynba Kathryn S.,
Indyk Justin A.,
Gandhi Kajal K.,
Buckingham Don,
Kamboj Manmohan K.
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13006
Subject(s) - medicine , metric (unit) , psychological intervention , quality management , diabetes mellitus , health care , type 2 diabetes , diabetes management , nursing , operations management , management system , engineering , economic growth , economics , endocrinology
Objectives The American Diabetes Association (ADA) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) have outlined standards for best practices in providing optimal diabetes care to children with type 1 diabetes (T1D). Our objectives were to design a metric that evaluated delivery of optimal diabetes care and to use this metric to drive improvement within our diabetes program. Methods Using published guidelines, we identified 11 elements of optimal diabetes care that should be reliably delivered at our institution as standard‐of‐care. We utilized our electronic medical record to aid in data collection and to notify staff when to deliver specific care elements (eg, lipid collection, depression screening, etc.). We designed the T1D Care Index (T1DCI), a metric which aggregates missed opportunities to deliver elements of optimal diabetes care over a given period into a cumulative score, with a lower T1DCI reflecting better care delivery and improved program performance. Results Tracking the T1DCI permitted recognition of areas to focus on quality improvement efforts, guided interventions to improve processes for care delivery, and helped determine the allocation of time and resources. Interventions resulted in improvement of care delivery across some elements of care. Overall, we observed a 26% reduction in the T1DCI after 12 months of utilization. Conclusions The T1DCI is a powerful metric to evaluate the ability of our diabetes program to standardize, quantify, and monitor delivery of optimal diabetes care to children with T1D, and to drive our program toward zero missed opportunities for quality care delivery.