TY - JOUR
T1 - Improved screening for cystic fibrosis-related diabetes by an integrated care team using an algorithm
AU - Rayas, Maria Socorro
AU - Willey-Courand, Donna Beth
AU - Lynch, Jane Lockwood
AU - Guajardo, Jesus Ramon
N1 - Publisher Copyright:
© 2013 Wiley Periodicals, Inc.
PY - 2014/10
Y1 - 2014/10
N2 - Objective: To determine whether implementation of a standardized, clinic-based algorithm improves compliance with cystic fibrosis-related diabetes (CFRD) screening guidelines.Study Design: A CFRD screening algorithm was developed as part of a quality improvement initiative through collaboration between the pediatric pulmonary and endocrine divisions and implemented prospectively to children aged 8-17 years in our CF center for a 6-month period. The primary outcome measure was the percentage rate of CF patients who were appropriately screened with an oral glucose tolerance test (OGTT) during the quality improvement period as compared to the year prior.Results: Ninety-seven percent (37/38) of OGTTs were appropriately ordered by providers, and 89% (34/38) of patients obtained the OGTT at the completion of the quality improvement period. Compared with the percentage of eligible patients completing the OGTT the year prior, the use of the algorithm significantly improved screening (P0.03). Data collected 1-year post-algorithm implementation revealed 97% (33/34) of OGTTswere ordered and 79% (27/34) of OGTTs were completed. The use of the algorithm 1-year post-implementation did not reveal a significant improvement in screening when compared to the reference year and implementation period (P0.08).Conclusions: Implementation of a clinical algorithm resulted in a statistically significant improvement in screening during the quality improvement period, but this improvement was not sustained the following year despite continued physician compliance with ordering the OGTT. Barriers to patient compliance need to be explored.
AB - Objective: To determine whether implementation of a standardized, clinic-based algorithm improves compliance with cystic fibrosis-related diabetes (CFRD) screening guidelines.Study Design: A CFRD screening algorithm was developed as part of a quality improvement initiative through collaboration between the pediatric pulmonary and endocrine divisions and implemented prospectively to children aged 8-17 years in our CF center for a 6-month period. The primary outcome measure was the percentage rate of CF patients who were appropriately screened with an oral glucose tolerance test (OGTT) during the quality improvement period as compared to the year prior.Results: Ninety-seven percent (37/38) of OGTTs were appropriately ordered by providers, and 89% (34/38) of patients obtained the OGTT at the completion of the quality improvement period. Compared with the percentage of eligible patients completing the OGTT the year prior, the use of the algorithm significantly improved screening (P0.03). Data collected 1-year post-algorithm implementation revealed 97% (33/34) of OGTTswere ordered and 79% (27/34) of OGTTs were completed. The use of the algorithm 1-year post-implementation did not reveal a significant improvement in screening when compared to the reference year and implementation period (P0.08).Conclusions: Implementation of a clinical algorithm resulted in a statistically significant improvement in screening during the quality improvement period, but this improvement was not sustained the following year despite continued physician compliance with ordering the OGTT. Barriers to patient compliance need to be explored.
KW - Children
KW - Cystic fibrosis
KW - Indeterminate glucose tolerance
KW - Oral glucose tolerance test
KW - Quality improvement
UR - http://www.scopus.com/inward/record.url?scp=84908213779&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84908213779&partnerID=8YFLogxK
U2 - 10.1002/ppul.22988
DO - 10.1002/ppul.22988
M3 - Article
C2 - 24436252
AN - SCOPUS:84908213779
SN - 8755-6863
VL - 49
SP - 971
EP - 977
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
IS - 10
ER -