“Time and time again we have heard this year that you should never let a crisis go to waste." Famous words immortalised by Machiavelli and Winston Churchill... and by many people after them. These words reflect the need for rapid answers, that the crisis is an opportunity to do things you think you could not do before and that the solution may well be found outside the usual compass.
The RCPCH National Diabetes Quality Programme (NDQP), established in 2018, aims to improve care, outcomes and quality of life for children and young people with diabetes and their families. Considering the UK has the world’s 5th highest rate of Type 1 diabetes in children aged up to 14, everyone involved in the Programme was keen to continue supporting paediatric diabetes units during the COVID-19 outbreak.
The NDQP can be defined by three main activities in which paediatric diabetes service take part in: peer reviews; an annual self-assessment to track and report on progress and identify common areas for improvement; and a Quality Improvement (QI) Collaborative offering multidisciplinary teams the support and tools to identify, design and analyse their own interventions specific to the needs of the patients and families they care for.
Following the national lockdown, formal QI training and peer reviews were postponed for a few months while the pandemic implications were better understood. This gave paediatric diabetes services the time and space to adapt and deal with it. We also needed time to adapt and innovate our approach!
[Participants] cited that virtual reviews have run smoothly, clinicians have felt carefully listened to...
As a result, the programme has been delivered virtually since June, and will continue to be until at least the end of 2020. This has certainly provided added challenges including IT connectivity issues, less familiarity with a virtual approach, time needed to set up and coordinate all online activities and a natural preference for face-to-face interaction. However, having had nine virtual peer reviews so far, we have received very positive feedback from paediatric diabetes services, senior management teams and peer reviewers. They've cited that reviews have run smoothly, clinicians have felt carefully listened to and that participating in peer reviews remotely has been much easier in terms of travelling, spending time away from home and childcare.
Formal virtual QI training will commence this September, with innovative activities to keep paediatric diabetes services inspired and focused. The NDQP now has its own YouTube playlist with short instructional QI refreshers perfect for services’ QI journeys. We have also developed a series of podcasts in which we host open, honest, and motivating discussions on all aspects of QI in children and young people's (CYP) diabetes services. Finally, live webinars are also being hosted on relevant topics with knowledgeable experts from CYP diabetes services. These have also received positive feedback, giving services the confidence to try new things during this period in the hope they will change practice for the better.
Virtual activities would not have been possible without the collaboration of trailblazer services that have agreed to take part on these activities, and the support of the CYP Diabetes Network encouraging participation.
Most importantly, the ethos and aims of the NDQP remain the same albeit with a few logistical changes. Hopefully, outcomes will show that we did not let this crisis go to waste.