Cleveland Clinic Children's Outcomes

Congenital hypothyroidism is a condition in which the thyroid gland is not functioning properly or hasn’t formed. This causes a deficit of thyroid hormone which is critical to brain development in children less than 3 years of age. We have created a dashboard within our EMR that is helping us now more closely track these patients to make sure they are being seen so that their growth and development can be monitored as well as making sure they are getting lab work done in a timely manner to maximize treatment and prevent developmental delays.

A1C Clinic is a clinic to help children and adolescents with relatively uncontrolled diabetes (high A1C’s) and/or frequent hospitalizations for diabetes improve their health and well-being by achieving better diabetes control. The team includes physicians and nurse practitioners, psychologists, dieticians, and social workers. The clinic is for any aged child or adolescent with any type of diabetes. The goal of the program is to partner with the child and caregivers to help achieve more stable blood sugars, decrease hospital admissions for uncontrolled diabetes, increase independence, overcome challenges, and learn new skills.

Average A1C: The results show that for patients newly participating in the A1C Clinic in each year, there is, on average, a small decrease in A1C 1 year after first visit compared to the A1C at the initial visit. In certain individuals, the decrease in A1c is greater. These small average A1C changes reflect the continued challenges we collectively face: diabetes is a condition that affects all aspects of life and optimal control is limited by one’s unique and complex social milieu, comorbid mental health conditions, and comorbid medical conditions. We continue to strive for equity in care for our patients with diabetes, regardless of each individual’s personal challenges and strengths.

Admissions: The results show that for patients newly participating in the A1C Clinic in 2021 and 2022, the total number of diabetes-related hospital admissions decreased in the first year of participation compared to the year prior to participation. For patients newly participating in 2023, the number of diabetes-related hospital admissions increased in the first year of participation compared to the year prior. This change is due to a small number of individuals who were newly enrolled in the program (possibly as a result of new diagnosis of diabetes or transfer of care from other hospital systems) who each had several diabetes-related admissions. We expect the number of admissions to decrease as these patients continue to work with our team.