Allison Moreau, R.R.T., from the Hartford Adult CF Clinic looks on as adult CF patient Jennifer Whinnem takes a pulmonary function test during the recent Quality Improvement Summit at the Central Connecticut CF Care Center in Hartford.
If you do the same, you stay the same. This has become the mantra of the Central Connecticut CF Care Center in Hartford. Hoping to improve care at their center, the care center staff embraced their mantra and welcomed the CF Foundation’s Quality Improvement (QI) Initiative, a program aimed at raising the quality of care bar in CF care centers.
“From the time the Foundation launched the Quality Improvement Initiative in 2002, our team wanted to be involved,” said Craig Lapin, M.D., director of the Central Connecticut CF Center. “We saw this as an exciting opportunity to improve the care we provide our CF patients and improve their health outcomes.”
The QI Initiative supplies CF care centers with the knowledge and tools to assess how they are functioning as care teams. Clinical Practice Guidelines, mentoring programs for caregivers and care team visits to other centers with superior outcomes allow individual care centers to evaluate their own practices and determine how they can improve.
“Our first step in our QI effort was to seek input from everyone involved in treating CF – doctors, patients and families alike – to identify any gaps in patient care,” said Lapin. To do this, the center created two teams, an internal professional committee and a Patient Family Advisory Board consisting of CF patients and their families. By getting input from patients and families, the center was able to identify improvement needs that they otherwise may not have seen.
Equipped with their QI tools, the care team set out to improve their center. They began by scrutinizing their current pulmonary practices and CF care guidelines. Next, they made sure that all team members were carrying out treatment and testing in accordance with best practices. Finally, they developed a patient action plan for patients and families in the clinic, which set clear goals for therapy between visits and developed customized programs for patients with difficulty following treatment protocols.
Lapin and his team turned their QI techniques into better health for their CF patients. The center saw great improvement in both lung function and nutritional outcomes. “The improved outcomes of our patients have made all of our efforts worthwhile and provided the impetus for us to continue our QI work,” said Ginny Drapeau, the center’s nurse coordinator.
Buoyed by their successes, the center plans to focus future QI efforts on the transition from pediatric to adult care and adherence issues. They will track the number of appointments kept during transition periods and assess the readiness of young adults to manage their own care. To address adherence issues, the center will monitor the number of missed medications and treatments, and whether or not they are being given or performed correctly. The staff will work with patients and families to develop programs to make transition and adherence better.
Because the Central Connecticut CF Center achieved such impressive results, it was chosen to host a QI summit earlier this year. CF caregivers from around the nation visited the center, studied Connecticut’s successful strategies and brought them home in an effort to improve their own outcomes.
Rick Knauft, M.D., adult program director of the Central Connecticut CF center, said this is really an example of the CF Foundation’s QI Initiative coming full circle. “Just a few years ago we were attendees in the QI Initiative and the CF Foundation gave us the opportunity to visit a high-performing CF site. Now participants in the QI Initiative are visiting and learning from us.”
“We can’t afford to stand still while we are working to beat CF. We have set ourselves targets and goals,” said Lapin. “QI is really about making a firm commitment to achieve those goals and improve the way you take care of the CF community.”