Improving lung function in adolescents with CF by tracking annual rate of lung function decline
Sydney Schiff1,2, Miah Starks3, Rachel W Linnemann3,4
1Cystic Fibrosis Program, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia, USA Sydney.schiff@choa.org.
BMJ Open Quality
|August 13, 2021
Summary
Quality improvement initiatives helped slow lung function decline in adolescent cystic fibrosis (CF) patients. This proactive approach improved lung health, especially for those with high baseline lung function.
Area of Science:
- Pulmonology
- Pediatric Care
- Quality Improvement Science
Background:
- Maintaining lung function in adolescents with cystic fibrosis (CF) is critical for long-term health.
- Adolescents with high per cent predicted forced expiratory volume in 1 s (ppFEV1) may experience less intensive monitoring, risking undetected lung function decline.
- Early detection and aggressive treatment are key to preserving lung function in CF patients.
Purpose of the Study:
- To implement and evaluate quality improvement (QI) initiatives aimed at identifying and treating rapid lung function decline in adolescent CF patients.
- To improve the standardized monitoring and management of lung health in pediatric CF care.
Main Methods:
- The Emory+Children's Pediatric Cystic Fibrosis Program introduced five QI initiatives: lung zones, individual decline tables, a lung health algorithm, a rapid decliner checklist, and automated data reports/scorecards.
- These interventions were tested and refined using plan-do-study-act cycles.
Main Results:
- Implementation of QI initiatives led to overall improvements in lung function among adolescent CF patients.
- A significant slowing of lung function decline was observed in the adolescent CF population.
- The standardized, proactive approach and increased clinician attention contributed to improved outcomes, particularly for patients with high baseline ppFEV1.
Conclusions:
- Quality improvement initiatives can effectively slow lung function decline in adolescents with CF.
- A standardized and proactive approach to monitoring and managing lung function is crucial for preserving lung health in CF patients.
- Targeted interventions can improve outcomes even in patients with initially high lung function.
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