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Improving screening for cystic fibrosis-related diabetes at a pediatric cystic fibrosis program
Andrew S Kern1, Adrienne L Prestridge
1Department of Otolaryngology-Head and Neck Surgery, The Wexner Medical Center at Ohio State University, Columbus, Ohio 60611-2605, USA. a-kern@fsm.northwestern.edu
Insights
Screening rates for cystic fibrosis-related diabetes (CFRD) significantly improved after implementing a new outpatient system in a pediatric cystic fibrosis (CF) program. The initiative increased annual oral glucose tolerance test (OGTT) completion for eligible patients.
Area of Science:
- Pediatric Endocrinology
- Pulmonology
- Quality Improvement in Healthcare
Background:
- Guidelines recommend annual oral glucose tolerance tests (OGTT) for cystic fibrosis (CF) patients aged 10 years and older to screen for cystic fibrosis-related diabetes (CFRD).
- Screening rates for CFRD were historically low at the pediatric CF center, indicating a gap in adherence to established guidelines.
Purpose of the Study:
- To implement an effective, evidence-based outpatient screening system for CFRD within a pediatric CF program.
- To improve the rate of annual OGTT screening for eligible CF patients.
Main Methods:
- A systematic quality improvement initiative was developed, incorporating structured patient education, enhanced family communication, and streamlined laboratory appointment scheduling.
- The primary outcome measured was the proportion of eligible patients receiving an OGTT by their subsequent clinic appointment.
- Longitudinal tracking of the percentage of patients without CFRD who received an OGTT within the preceding 12 months was also conducted.
Main Results:
- The outpatient screening rate for CFRD increased dramatically from 2% to 78% within 18 weeks post-implementation (P < .001).
- Compared to the previous year, the screening rate also significantly improved from 35% to 78% (P < .001).
- The overall percentage of patients without CFRD receiving a timely OGTT rose from 47% to 71% (P = .003).
Conclusions:
- A systematic, quality improvement approach is effective in enhancing outpatient CFRD screening rates in pediatric CF programs.
- The implemented system successfully addressed low screening rates, improving adherence to recommended guidelines for CFRD detection.
Objective:
Despite guidelines recommending an annual oral glucose tolerance test (OGTT) for all patients with cystic fibrosis (CF) aged ≥ 10 years, screening rates for cystic fibrosis-related diabetes (CFRD) remained low at our center. The aim of this project was to implement an outpatient system to provide effective, evidence-based screening for CFRD at a pediatric CF program.
Methods:
Development of a system to improve outpatient screening for CFRD included structured education, communication with families, and processes for scheduling laboratory appointments. The primary outcome measure was the proportion of eligible patients seen at the clinic who received an OGTT by the subsequent clinic appointment. The proportion of patients without CFRD in our program who received an OGTT within the previous 12 months was also tracked longitudinally.
Results:
The outpatient screening rate for CFRD increased from 2% of eligible patients seen at the clinic during the 18 weeks before the start of our initiative to 78% during the 18 weeks after the start of our initiative (P < .001). The screening rate was also increased from the corresponding date range the previous year, when only 35% of eligible patients received an OGTT (P < .001). The overall percentage of patients without CFRD in our program who received an OGTT in the previous 12 months increased from 47% to 71% after implementation of our initiative (P = .003).
Conclusions:
A systematic, quality improvement approach effectively increased the rate of outpatient screening for CFRD at a pediatric CF program.
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