• Lynn A Burmeister, Peter G Harper, Alvina Brueggemann, Patricia Adam, Mary Logeais, Kelly Schechter, Katie Duncan, and Holly Boyer.
• Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USA. burme008@umn.edu.
• J Gen Intern Med. 2022 Nov 1; 37 (15): 400440074004-4007.

IntroductionEndocrine specialty clinics (SCs) are occupied by a high percentage of stable follow-up patients, limiting access to new patients with greater needs.AimFeasibility project to improve access to diabetes SC by reducing the number of stable optimally controlled follow-up type 2 diabetic patients.SettingM Health Fairview (MHFV), a hybrid network of University of Minnesota academic and Fairview Health community hospitals and clinics with affiliated providers.Program DescriptionA team-based lean methodology quality improvement graduation program including medical assistants, nurses, physicians, and a compact with primary care (PC) was used to identify within the Endocrine clinic population the graduation-eligible optimally controlled stable type 2 diabetic patients, acclimate them to the graduation concept, engage in shared decision-making, and transition them back to PC with a warm hand-off and graduation certificate.Program EvaluationSeventeen percent (58/341) of eligible patients with optimally controlled diabetes graduated by 6 months, ranging between 0 and 83% per week.DiscussionThe innovation and feasibility of opening SC access through the use of a team-based graduation program to transfer stable diabetes patients back to their home clinic was demonstrated. This innovation has the potential to support health system triage of new patients to limited access specialty care.© 2022. The Author(s).

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