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A3633 - Educational Initiative to Improve the Team-Based Care of Patients with IPF
Author Block: E. R. Fernandez Perez1, P. Zelarney2, S. Thomas3, D. A. Shoop3, J. L. Munson3, K. D. Johnson3, M. E. Stern4, S. Meadows4; 1Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, United States, 2Research Informatics, National Jewish Health, Denver, CO, United States, 3Nursing, National Jewish Health, Denver, CO, United States, 4Professional Education, National Jewish Health, Denver, CO, United States.
Background: The management of idiopathic pulmonary fibrosis (IPF) is complex, as is the process of implementing and assessing a set of quality indicators representing best care practices in IPF by an interstitial lung disease (ILD) program. Methods: Eight metrics were followed over one year (N=587) with physicians individually and as an ILD group aggregate, compared to a calendar year 2014 baseline (N=276). Metrics reviewed each quarter of 2016 included immunizations recorded, 6-minute walk test ordered, nocturnal oximetry ordered, weight loss intervention, pulmonary rehabilitation referral, oxygen titration ordered for new patients, referral to education, and reflux discussion. IPF patients were surveyed at initiative conclusion, and focus groups conducted among patients and ILD division nurses. Results: Documentation related to all eight-metrics improved from 27% at baseline to 65% at Q4 2016. While this documentation significantly improved, patient surveys (N=50) indicated that many, and often the majority, of patients do not recall their provider discussing important issues of IPF disease expectations and management. Focus group analysis indicates similar conclusions, but when we introduced a “IPF patient education activation card”, it was regarded an important part of a conversation with a clinician at the time of diagnosis. Similar too was the nurse focus group feedback: the patient education activation card was critical if a process flow was put in place in clinic, because it allowed them to approach or continue important conversations at the appropriate time for the patient. Conclusions: We identified a need for improved documentation of quality indicators and evaluated the effect of an IPF patient education activation card in promoting a patient-centered IPF team-based approach. The initiative was successful in improving best care practices and identifying needs for helping our IPF patients understand and manage the disease.