Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic
Autor: | Nancy Kubiak, Karim El-Kersh, Udit Chaddha, Takudzwa Mkorombindo, Robert M. Burkes, Alok Bhatt, Rodrigo Cavallazzi |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Spirometry
medicine.medical_specialty Quality management Leadership and Management medicine.medical_treatment education Pulmonary disease lcsh:Medicine Health Informatics vaccinations Article quality improvement 03 medical and health sciences 0302 clinical medicine Health Information Management Internal medicine Medicine 030212 general & internal medicine COPD medicine.diagnostic_test business.industry Health Policy lcsh:R Airway obstruction medicine.disease respiratory tract diseases smoking cessation Vaccination 030228 respiratory system Medical Education Pneumococcal vaccination Smoking cessation pulmonary diseases business |
Zdroj: | Healthcare Volume 6 Issue 3 Healthcare, Vol 6, Iss 3, p 88 (2018) |
ISSN: | 2227-9032 |
Popis: | Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Guideline-discordant care of COPD is not uncommon. Further, there is a push to incorporate quality improvement (QI) training into internal medicine (IM) residency curricula. This study compared quality of care of COPD patients in an IM residents&rsquo clinic and a pulmonary fellows&rsquo clinic and, subsequently, the results of a quality improvement program in the residents&rsquo clinic. Pre-intervention rates of quality measure adherence were compared between the IM teaching clinic (n = 451) and pulmonary fellows&rsquo clinic (n = 177). Patient encounters in the residents&rsquo teaching clinic after quality improvement intervention (n = 119) were reviewed and compared with pre-intervention data. Prior to intervention, fellows were significantly more likely to offer smoking cessation counseling (p = 0.024) and document spirometry showing airway obstruction (p < 0.001). Smoking cessation counseling, pneumococcal vaccination, and diagnosis of COPD by spirometry were targets for QI. A single-cycle, resident-led QI project was initiated. After, residents numerically improved in the utilization of spirometry (66.5% vs. 74.8%) and smoking cessation counseling (81.8% vs. 86.6%), and significantly improved rates of pneumococcal vaccination (p = 0.024). One cycle of resident-led QI significantly improved the rates of pneumococcal vaccination, with numerical improvement in other areas of COPD care. |
Databáze: | OpenAIRE |
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