Transitioning From Race-Specific to Race-Neutral Reference Equations for Pulmonary Function Test Interpretation at a...

Area of Science:

• Pulmonary Medicine
• Health Equity
• Medical Guidelines

Background:

• The American Thoracic Society (ATS) issued a statement in April 2023 advocating for race-neutral reference equations in Pulmonary Function Test (PFT) interpretation.
• Implementing these race-neutral guidelines presents a significant challenge due to the absence of a clear implementation strategy.
• Existing race-specific PFT equations have been a standard in clinical practice, raising questions about the transition process.

Purpose of the Study:

• To outline a systematic approach for transitioning from race-specific to race-neutral reference equations for PFT interpretation.
• To provide a practical framework that other healthcare institutions can adapt for implementing the ATS recommendation.
• To address the challenge of operationalizing updated PFT interpretation guidelines in a large, safety-net hospital setting.

Main Methods:

• The study details a transition process at a large, safety-net hospital.
• The implementation strategy was guided by the principles of the Kotter Change Model.
• Key steps involved stakeholder engagement, education, and data system adjustments.

Main Results:

• The hospital successfully transitioned to using race-neutral reference equations for PFT interpretation.
• The adopted framework facilitated a systematic and organized change process.
• The transition aimed to improve the accuracy and equity of PFT results.

Conclusions:

• A structured approach, informed by change management models, can effectively facilitate the adoption of race-neutral PFT equations.
• The outlined methodology offers a replicable model for other institutions facing similar implementation challenges.
• This transition supports the ATS's goal of promoting health equity in respiratory care.