Increasing Efficiency in Evaluation of Chronic Cough
| Autor: | Cynthia M. Patton, Kathleen M. White, Luke W. Ramlow, Kaiser G. Lim |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Health (social science) Quality management Leadership and Management Psychological intervention Multidisciplinary approach Patient-Centered Care Outcome Assessment Health Care Health care medicine Humans Cooperative Behavior Disease management (health) Care Planning Retrospective Studies business.industry Health Policy Medical record Disease Management Retrospective cohort study medicine.disease Chronic cough Cough Chronic Disease Physical therapy Female Medical emergency medicine.symptom business |
| Zdroj: | Quality Management in Health Care. 24:177-182 |
| ISSN: | 1063-8628 |
| DOI: | 10.1097/qmh.0000000000000072 |
| Popis: | Chronic cough is the most common reason for medical office visits in the United States. The typical patient has coughed more than 8 years and seen many specialists. This quality improvement project is an ambulatory clinic redesign to deliver efficient, patient-centered care with interspecialty collaboration. Methodology included the Institute for Healthcare Improvement collaborative model focused on Lean/Six Sigma and ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) Change Management. Interventions targeted education to referring providers, implementation of software changes, building a collaborative interdepartmental scheduling decision tree, and an interclinic dashboard enhancing communication and decision support. Outcome measures compare group resource utilization, evidenced by the total number of specialist referrals for same indication of chronic cough (International Classification of Diseases, Ninth Revision: 786.2), and length of time to complete evaluation. A retrospective review of 165 medical records yielded 2 groups, "current care" (n = 67) and "intervention" (n = 68). The number of specialist referrals per patient was reduced in the intervention group (M = 1.22, SD = 0.48) compared with the current care group (M = 3.33, SD = 1.02). Length of itinerary was reduced in the intervention group (M = 11.90, SD = 12.13, GM = 6.82) compared with the current care group (M = 126.93, SD = 158.13, GM = 54.8). Multidisciplinary collaboration, communication, coordinating diagnosis, and management of multifactorial conditions, such as chronic cough, are associated with lower costs and decreased utilization of health care resources. |
| Databáze: | OpenAIRE |
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