Improved screening for cystic fibrosis-related diabetes by an integrated care team using an algorithm

Maria Socorro Rayas, Donna B Willey-courand, Jane L Lynch, Jesus R Guajardo

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Objective: To determine whether implementation of a standardized, clinic-based algorithm improves compliance with cystic fibrosis-related diabetes (CFRD) screening guidelines.

Original languageEnglish (US)
Pages (from-to)971-977
Number of pages7
JournalPediatric Pulmonology
Volume49
Issue number10
DOIs
StatePublished - 2014

Fingerprint

Glucose Tolerance Test
Cystic Fibrosis
Quality Improvement
Patient Compliance
Outcome Assessment (Health Care)
Guidelines
Pediatrics
Physicians
Lung

Keywords

  • Children
  • Cystic fibrosis
  • Indeterminate glucose tolerance
  • Oral glucose tolerance test
  • Quality improvement

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Improved screening for cystic fibrosis-related diabetes by an integrated care team using an algorithm. / Rayas, Maria Socorro; Willey-courand, Donna B; Lynch, Jane L; Guajardo, Jesus R.

In: Pediatric Pulmonology, Vol. 49, No. 10, 2014, p. 971-977.

Research output: Contribution to journalArticle

Rayas, Maria Socorro ; Willey-courand, Donna B ; Lynch, Jane L ; Guajardo, Jesus R. / Improved screening for cystic fibrosis-related diabetes by an integrated care team using an algorithm. In: Pediatric Pulmonology. 2014 ; Vol. 49, No. 10. pp. 971-977.
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abstract = "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.Objective: To determine whether implementation of a standardized, clinic-based algorithm improves compliance with cystic fibrosis-related diabetes (CFRD) screening guidelines.",
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