Increasing Efficiency in Evaluation of Chronic Cough: A Multidisciplinary, Collaborative Approach
Cynthia M Patton1, Kaiser G Lim, Luke W Ramlow
1Division of Pulmonary and Critical Care Medicine (Drs Patton and Lim) and Department of Systems and Procedures (Mr Ramlow), Mayo Clinic, Rochester, Minnesota; and the Department of Acute and Chronic Care, Johns Hopkins School of Nursing, Baltimore, Maryland (Dr White).
Quality Management in Health Care
|October 2, 2015
Summary
Redesigning ambulatory clinics improved chronic cough care by reducing specialist referrals and evaluation time. This patient-centered approach enhanced efficiency and resource utilization for complex conditions.
Area of Science:
- Quality Improvement in Healthcare
- Ambulatory Care Redesign
- Patient-Centered Medical Homes
Background:
- Chronic cough is a leading cause of medical visits, often involving prolonged patient suffering and extensive specialist consultations.
- Current care pathways for chronic cough frequently result in delayed diagnosis and inefficient resource utilization.
Purpose of the Study:
- To redesign an ambulatory clinic to provide efficient, patient-centered care for chronic cough through interspecialty collaboration.
- To evaluate the impact of clinic redesign on specialist referral rates and time to complete patient evaluation.
Main Methods:
- Utilized the Institute for Healthcare Improvement collaborative model, incorporating Lean/Six Sigma and ADKAR Change Management.
- Implemented interventions including provider education, software enhancements, a collaborative scheduling decision tree, and an interclinic communication dashboard.
Main Results:
- The intervention group showed a significant reduction in specialist referrals per patient (1.22 vs. 3.33).
- The intervention group experienced a substantial decrease in the length of time to complete evaluation (6.82 days vs. 54.8 days).
Conclusions:
- Multidisciplinary collaboration and improved communication are key to managing multifactorial conditions like chronic cough.
- Clinic redesign initiatives can lead to lower healthcare costs and decreased utilization of resources for chronic cough management.
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