P-211: Incorporating transition education during a diabetes clinic visit: implementation of a transition to adult care readiness assessment initiative in type 1 diabetes clinic in a large institution
K M C Hong, J Indyk, T Sapper, B Edwards, M Abdelhadi, W Wayne, A Peoples, E Klamet, D Buckingham, M K KambojAbstract
Introduction
Acquiring type 1 diabetes (T1D) self-management skills during adolescence is positively correlated to adherence and in-target glycemic outcomes in adulthood. Transition education can begin as early as age 14 yrs, by annual administration of the transition readiness assessment (TRA) questionnare. We have shown that automation of the transition readiness assessment (TRA) increased completion rates. Transition education is tailored based on knowledge gaps.
Objectives
Continue the use of a transition readiness pathway (using TRA) by documenting the transition planning education 0% to 90% by December 31, 2026.
Methods
Adolescents are screened by the TRA annually. The provider or diabetes nurse educator (DNE) provides education based on results. A dot phrase was created to track the discussion. Education and reminders were conducted at faculty and department meetings on the use of the dot phrase during clinic visits. Eventually, DNEs were tasked as champions to lead transition education, and positive reinforcement was provided to individual users.
Results
Between 2024-2025, 4,916 (83%) of 5,890 total T1D clinic visits had a complete TRA. Education and reminders for providers to review TRA results show that the dot phrase use remained within the control limits and highest single point was only 17%. TRA dot phrase use increased three-fold after DNEs were designated as champions. Fig.
Conclusions
Reminders to providers to review the TRA results were helpful, but over time transition education was not provided or not captured. With many diabetes standards of care guidelines to complete, transition education discussions were not on the forefront. When accountability was designated to an DNE role, documented transition planning education significantly increased. In 2026, the next phase requires standardization of reviewing TRA results and providing education.