Improving Planning for Transition to Adult Care in a Pediatric Diabetes Clinic

Children’s Mercy Kansas City (CMKC) is a comprehensive nonprofit pediatric health system based in Kansas City, MO. Uniquely situated at the state border of Missouri and Kansas, CMKC provides care to a geographically, socioeconomically, and ethnically diverse population of patients and families from across the Midwest.

The Children’s Mercy Diabetes Center is a member of the T1D Exchange Quality Improvement Collaborative (1) and serves ~2,600 children, youth, and young adults through the age of 21 years with diabetes. It has four primary clinic locations: two in the Kansas City metropolitan area and the others located in central Kansas, including one in Topeka, the Kansas state capital, and one in Wichita, the largest city in the state. Additionally, there are four satellite locations in the Kansas City metropolitan area and three tele-facilitated outreach practices in rural locations across Kansas and Missouri, including Joplin, MO, Junction City, KS, and Great Bend, KS. The Great Bend outreach clinic is staffed by Wichita clinicians, whereas the satellite and other outreach clinics are staffed by clinicians from Kansas City. All clinicians can also provide telehealth services to patients at home, as needed. The Topeka, Wichita, and Great Bend clinics were not included in the interventions and analysis discussed here.