SAT-600  Improving the iLet Bionic Pancreas Onboarding Workflow in an Academic Outpatient Diabetes Clinic

Abstract Disclosure: M. Wei: None. M. Hunt: None. S. Masih: None. J. Spalding: None. N. Ross: None. R.Y. Gianchandani: None. The iLet by Beta Bionics is a novel automated insulin delivery (AID) system which does not require intense patient engagement including carbohydrate counting or significant provider intervention. The iLet quickly brings blood glucose (BG) into a tighter range, but this can be uncomfortable for some patients with longstanding hyperglycemia. Our academic institution has not fully developed a standard process for iLet referral, pre-training counselling, or preparatory checklist for iLet training to ensure a successful transition to this device. This leads to poor patient experience and is a burden on certified diabetes care and education specialist (CDCES) resources. Physicians are less familiar with the intricacies of this device. Here we describe a quality improvement project to enhance provider, patient, and CDCES workflow to improve outcomes and satisfaction. Methods: Through sitting in observations of iLet training sessions and interview with our iLet trainers, CDCES staff, Beta Bionics representatives, and physicians, we collected information on pertinent issues. A Redcap questionnaire is distributed to patients and providers. The highest impact interventions are identified after conducting a root cause analyses for workflow delays, patient outcomes, and experience. Results: A total of 19 patients have undergone iLet training in our clinic. Using their experiences, we built a detailed process map of the iLet onboarding process and identified key enhancement areas. Physician education, ordering, and documentation were targeted. The onboarding status of referred patients is not clearly communicated between the CDCES team and the physicians causing delayed patient preparation. Prior to training, patients must review iLet materials or, if not possible, a trainer must assist in iLet training preparation. Missing patient supplies delay or postpone the iLet training session and are a big inefficiency. Lastly, consistent follow-up after pump start is extremely important with the iLet AID, specifically related to food intake for training the device algorithm. Several key interventions have been developed starting with realistic and timely BG optimization to prevent relative hypoglycemia after iLet initiation. A “dot phrase” checklist is created for provider iLet referral and includes glucose sensor compatibility, data sharing, and integration as well as insurance required labs. We created a CDCES appointment template for pre-iLet training CDCES visit to review iLet training videos, discuss meal log, confirm iLet app set up, and review required supplies. Discussion: We anticipate our interventions will make iLet training more streamlined and efficient in our clinic and lead to improved physician and patient experience and outcome. Presentation: Saturday, July 12, 2025