ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 66 S4.2 | DOI: 10.1530/endoabs.66.S4.2

QI in action - the Sheffield Children's Hospital experience

Carrie MacKenzie & Sheffield Children’s Diabetes Team

Sheffield Children’s Hospital NHS FT, Sheffield, UK

The Sheffield Children’s Diabetes Team [SCDT] look after approximately 240 patients with Type 1 Diabetes aged 0–17 years. We have approximately 35 newly diagnosed patients each year and the level of social deprivation amongst our clinic population is high. Historically the team has always performed well in terms of measured outcomes and in the 2014–2015 National Paediatric Diabetes Audit [NPDA] data we ranked amongst the top five units in the country with a mean clinic HBA1c of 62.8 mmol/mol and 38.4% of patients having an HBA1c of <58 mmol/mol. In subsequent years our ranking fell with an increase in mean HBA1c [64.3 mmol/mol in 2016–2017] and only 28.6% of patients achieving an HBA1c < 58 mmol/mol. The invitation to participate in the Royal College of Paediatrics and Child Health [RCPCH] Diabetes Quality Improvement [QI] pilot project afforded us the opportunity to address our relatively poor outcomes using QI methodology. We recognised a particular problem in our clinic population with control in the first year after diagnosis with Type 1 Diabetes and identified the need for change to enable and empower our patients to achieve improved outcomes by providing patients and families with individualised, bespoke education. Our QI aim is to enable and support service users to achieve an HBA1c of 48 mmol/mol at 3 and 12 months post diagnosis. Our interventions so far include: carbohydrate counting from diagnosis whilst an in-patient; micro-teaching in the clinic waiting area; revised team aims and Diasend downloading at home from diagnosis. The ongoing collection and analysis of metrics has been fundamental to the modification of our interventions and early data has been encouraging. Our data [including average blood glucose and HBA1c results] will be presented.

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