UPMC Children’s Pediatric Endocrinology Division Joins Type 1 Diabetes Exchange Quality Improvement Collaborative

The Division of Pediatric Endocrinology at UPMC Children’s Hospital of Pittsburgh, one of the leading clinical and academic programs caring for youth with diabetes and endocrine disorders, has a more than seven-decade history of advancing clinical care, research, and outcomes for patients.

A fundamental pillar of the Division's work has focused on quality improvement opportunities across clinical settings and patient populations. With its consistent desire to improve the means, modes, and outcomes of the care it provides, the Division has recently joined the Type 1 Diabetes Exchange Quality Improvement Collaborative to further these goals and collaborate with like-minded centers to spur advances in care.

Leading the Division’s work with the collaborative is principal investigator Alissa Guarneri, MD, MBOE, assistant professor of Pediatrics. Dr. Guarneri joined the Division in late-2020 and serves as the Division’s Quality Improvement Coach, mentoring colleagues and fellows on quality improvement projects within the Division. She is also a member of the Department of Pediatrics Maintenance of Certification Part 4 Committee.

"Our team is excited to be a member of the collaborative, and we are working to scale up our participation and share our patient data with the registry while we work to develop our first quality improvement project as part of the collaborative," says Dr. Guarneri.

What is the Type 1 Diabetes Exchange Quality Improvement Collaborative?

The Type 1 Diabetes Exchange Quality Improvement Collaborative (T1DX-QIC) is a program developed by the Type 1 Diabetes Exchange, a nonprofit organization that aims to improve care and outcomes for people with type 1 diabetes. T1DX-QIC currently brings together 54 clinics across the U.S., collectively treating more than 100,000 individuals with type 1 diabetes. T1DX-QIC member clinics share data via the T1D QIC portal to measurably improve the lives of individuals with type 1 diabetes. The QIC has achieved unprecedented success because it relies on an embedded and systemic approach: individual providers are empowered to identify areas of unmet need within their respective clinics. They make targeted changes in care that scale up through the QIC to create best practices shared and implemented by members at other clinics.

The T1DX-QIC focuses on several critical areas of type 1 diabetes care, including glycemic control, blood pressure management, lipid management, and screening for complications. By participating in the T1DX-QI program, centers can learn from each other's experiences, share patient registry data and best practices, and work together to improve the quality of care for individuals with type 1 diabetes.

Ingrid Libman, MD, PhD, director of diabetes programs at UPMC Children's, is a co-investigator in the project. "Dr. Guarneri's experience in quality improvement will allow us to expand on our efforts."

“Multicenter data registries like the T1DX-QI are critically important to advancing the care of patients with diabetes and improving our outcomes,” says Dr. Libman. “It allows for collaboration, access to larger data sets, and learning from a broader range of patients and practices than any one center can achieve on its own. Sharing and learning between institutions to improve quality of care and uniformity of evidence-based best practices is at the heart of this work.”

Important Collaboration with Adult Endocrinology Division Partners

For Drs. Guarneri and Libman, one of the more exciting aspects of joining the collaborative is their partnership with the UPMC adult Division of Endocrinology and Metabolism.

Collaborating with Dr. Guarneri are co-principal investigators Margaret Zupa, MD, MS, and Jason Ng, MD, who lead the adult Division's participation in the collaborative.

“Formally partnering with our adult colleagues in this work is a great opportunity to work together, share ideas, and solidify a deeper connection between our pediatric and adult diabetes clinics,” says Dr. Guarneri. “I also think our combined clinical power, patient data, and expertise in pioneering and developing improvements in diabetes care will be a great addition to the collaborative.”

Future QI Project Work

While still in the preliminary phases of setting up the necessary internal infrastructure and data sharing with the collaborative, Drs. Guarneri and Libman shared several possible future quality improvement projects to undertake.

“One of our areas of interest relates to the behavioral health aspects of care in patients with T1D, including screenings for depression,” says Dr. Guarneri. “We have some preliminary ideas for projects around this QI area and will be working to formalize our work over the coming months.”

More About the Type 1 Diabetes Exchange

T1D Exchange is a leader in harnessing data to advance type 1 diabetes (T1D) care and outcomes by driving collaborative change. Through real-world evidence and clinical data collection and analysis, novel insights such as identifying gaps in data and redefining best practices to improve the lives of those living with T1D are identified. T1D Exchange actively supports quality improvement and innovation through its Quality Improvement Collaborative, patient registry, and data-oriented research services. Through a knowledge-sharing and collaboration-focused approach, T1D Exchange is accelerating real-world impacts by providing clinicians, researchers, industry partners and advocates with the resources and services they need for better decision support and population health management. A nonprofit organization, T1D Exchange was established in 2010 with ongoing support from The Leona M. and Harry B. Helmsley Charitable Trust.