Diabetes Collaborative Project. A Quality improvement initiative for young people with HbA1c >10% — ASN Events
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Diabetes Collaborative Project. A Quality improvement initiative for young people with HbA1c >10% (#357)

Karen A Shann 1 , Marina Noud 2 , Matthew Walker 3 , Annie Franklin 1 , Andrew Cotterill 2 , Sandra Crook 4 , Victoria Green 5 , Jennifer Matthews 2 , Trevor Sadler 6 , Sudeep Sudeep 2 , David Irvine 7 , Alan Sive 1 4 , Sue Moloney 7 , Dyanne Wilson 8 , John Gavranich 9 , Katie Hawtin 10 , Naomi Holder 10 , Bonnie Macfarlane 10 , Elizabeth Wech 10 , Sarah Parlangeli 10 , Marie Jose Velasco 10
  1. Royal Children's Hospital, Brisbane, QLD, Australia
  2. Paediatric Mater Health Service, Brisbane, QLD, Australia
  3. Bundaberg Hospital, Bundaberg, QLD, Australia
  4. Townsville Health Service District, Townsville, QLD, Australia
  5. Diabetes Team, North Lakes Health Precinct, North Lakes, QLD, Australia
  6. Barrett Adolescent Centre for Mental Health, Brisbane, QLD, Australia
  7. Gold Coast Diabetes Service, Gold Coast, QLD, Australia
  8. Cairns Base Hospital, Cairns, QLD, Australia
  9. Ipswich Hospital, Ipswich, QLD, Australia
  10. Collaborative project, Brisbane, QLD, Australia

Background:- Adolescents with poor glycaemic control at 16 years of age have a 1 in 2 chance of major complications by the age of 25. A reduction in HbA1c of 1% achieves a 50% reduction in risk. In Queensland the mean HbA1c of young people with T1DM has been high (8.9%) (1998-2007) with 20% with HbA1c persistently >10%

Aims:- To reduce HbA1c in adolescents and prevention of staff burn out through the developed of a Management Plan (handbook, flow chart, Record sheet, Action plan)

Method:-A 2010 needs analysis of 7 (5 non tertiary) diabetes teams across Queensland identified sub-optimal outcomes often lies with  psychosocial co-morbidities. A lack of psychosocial expertise and staff burnout were the main barriers to providing best practice care. Prior to initiation of the study team members attended a 3h in-service conducted by a psychologist to address assessment of psychosocial issues

Results:- Evaluation found 60% of the health professionals felt the Management Plan, with the psychosocial support, made a positive difference and the framework provided a consistent process for caring for adolescents  with complex psychosocial problems and HbA1c > 10%. It enabled team members to collaborate with the family to develop strategies to improve outcomes for the young people. Identified barriers were lack of time and resources.

Conclusion:- Following a management plan promoting patient centred and multidisciplinary care benefits the outcomes of young people with HbA1c >10% the initial burden of workload on the clinicians involved will reduce the longer term input