دورية أكاديمية
Improved recognition of lung function decline as signal of cystic fibrosis pulmonary exacerbation: a Cystic Fibrosis Learning Network Innovation Laboratory quality improvement initiative
| العنوان: | Improved recognition of lung function decline as signal of cystic fibrosis pulmonary exacerbation: a Cystic Fibrosis Learning Network Innovation Laboratory quality improvement initiative |
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| المؤلفون: | Jennifer Stewart, Don B Sanders, Neha Patel, Preeti Sharma, Lisa Mullen, Maria T Britto, Raouf S Amin, Stacy Bichl, Michael Powers, Martina Compton, Rhonda List, Dana Albon, Hossein Sadeghi, Clement Ren, Prigi Varghese, Pornchai Tirakitsoontorn, Maivy Sou, Golnar Raissi, Bean Corcoran, George Solomon, Bethany Jablonski Horton, Shiyi Shen, Christopher Siracusa, Kimberly Hodges, Shontae Hill, Kristen Ameel, Sarah Dykes, Johanna Zea-Hernandez Ben McCullar, Courtney Roberts, Elisabeth Debri, Dana Goodwin, Juliana Bailey, George Soloman, Erin Newbill, Misty Thompson, Rebecca L Kowal, Danielle Poulin, Cori L Daines, Glenda A Drake, David C Miller |
| المصدر: | BMJ Open Quality, Vol 12, Iss 4 (2023) |
| بيانات النشر: | BMJ Publishing Group |
| سنة النشر: | 2023 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Medicine (General), R5-920 |
| الوصف: | Introduction Cystic fibrosis (CF) is a systemic autosomal recessive condition characterised by progressive lung disease. CF pulmonary exacerbations (PEx) are episodes of worsening respiratory status, and frequent PEx are a risk factor for accelerated lung function decline, yet many people with CF (PwCF) go untreated at the time of decline. The goal of this quality improvement (QI) initiative was to improve recognition, treatment and follow-up of PEx in PwCF.Methods Using the Model for Improvement, the Cystic Fibrosis Learning Network (CFLN) initiated a QI innovation laboratory (iLab) with a global aim to decrease the rate of lung function decline in PwCF. The iLab standardised definitions for signals of PEx using a threshold for decline in forced expiratory volume in one second (FEV1) and/or changes in symptoms. The FEV1 decline signal was termed FIES (FEV1-indicated exacerbation signal). Processes for screening and recognition of FIES and/or symptom changes, a treatment algorithm and follow-up in the presence of a signal were tested concurrently in multiple settings.Specific aims The specific aim is to increase the per cent of PwCF assessed for a PEx signal at ambulatory encounters and to increase the per cent of recommendations to follow-up within 6 weeks for PwCF experiencing a PEx signal.Results FIES recognition increased from 18.6% to 73.4% across all teams during the iLab, and every team showed an improvement. Of PwCF assessed, 15.8% experienced an FIES event (>10% decline in FEV1 per cent predicted (FEV1pp)). Follow-up within 6 weeks was recommended for an average of 70.5% of those assessed for FIES and had an FEV1pp decline greater than 5%.Conclusion The CFLN iLab successfully defined and implemented a process to recognise and follow-up PEx signals. This process has the potential to be spread to the larger CF community. Further studies are needed to assess the impact of these processes on PwCF outcomes. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2399-6641 |
| العلاقة: | https://bmjopenquality.bmj.com/content/12/4/e002466.fullTest; https://doaj.org/toc/2399-6641Test; https://doaj.org/article/a153842b63fd4129bdccf236583a8006Test |
| DOI: | 10.1136/bmjoq-2023-002466 |
| الإتاحة: | https://doi.org/10.1136/bmjoq-2023-002466Test https://doaj.org/article/a153842b63fd4129bdccf236583a8006Test |
| رقم الانضمام: | edsbas.372C5F91 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 23996641 |
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| DOI: | 10.1136/bmjoq-2023-002466 |