University of Miami, Miami, Florida, USA

Background/Objective: The ADA publishes yearly care standards for pediatric patients with T1D.1 Participation in the T1D Exchange QI Collaborative has provided our clinic with additional resources to achieve these standards. This past year, we aimed to make improvements in the major driver area of “Diabetes Data Science” by creating a customized and comprehensive diabetes flowsheet for our clinic.

Methods: Our clinic started the process of creating the flowsheet by asking all team members to report the current components of their diabetes visits. These components were then divided into categories and subcategories, to be used as the framework for our flowsheet. We also incorporated the ADA care standards into our flowsheet.1

Results: Our IT department created a diabetes review flowsheet in our EHR (Epic) based on the information requested. As members of our diabetes team have utilized the flowsheet, modifications have been made accordingly. Our clinic is currently using the fourth iteration of the flowsheet. The major categories of the diabetes flowsheet are Diabetes Review, CDE/Physicians, Hypoglycemia, Hyperglycemia, Diabetes Treatment, Pump, Injections, Nutrition, Miscellaneous and CDE. After data has been entered, the flowsheet is integrated into the note for the patient encounter. All members of the diabetes team, including residents and students, can easily enter data into the flowsheet.

Conclusions: The diabetes flowsheet has proven to be an excellent tool that has improved standardization of diabetes care in our clinic. The flowsheet will also assist with future data collection and aid in transitioning patients to adult diabetes care.

References:

1. American Diabetes Association. 13. Children and Adolescents: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S180-S199. doi:10.2337/dc21-S013