960-P: Multisite Quality Improvement Initiative within the Project ECHO Diabetes Virtual Network

Poor outcomes for people with diabetes have necessitated targeted quality improvement (QI) projects to affect change. Project ECHO Diabetes is a tele-education and tele-mentoring program for community health clinics in California and Florida serving under-resourced patients with diabetes who lack routine access to specialty care. The model provided a unique opportunity to undertake a multi-site QI initiative, where 12 community clinics participated in measuring and improving quality of care. Using a modified-Delphi approach, clinic providers rated various QI measures on their validity and feasibility. A total of 18 measures were selected, and each clinic chose its own measures to track throughout the one-year initiative. The number of measures each clinic focused on ranged from 1 to 9, with a median of 3. Quarterly, clinics met remotely to report performance based on selected measures and discuss their efforts, successes, and setbacks. At the end of the QI year, clinics reported widespread improvements across structural, process, and outcome measures (Table) . Remarkable improvement ideas came from the sharing of best practices during the remote tele-ECHO clinic sessions and the changes made in the data systems used to track important measures. The Project ECHO Diabetes tele-education model has the potential to improve care for people living with diabetes in clinics serving under-resourced communities.