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Using real-time data to improve patient no-shows and late cancellations
Journal of Cystic Fibrosis ; 21(Supplement 2):S66, 2022.
Artículo en Inglés | EMBASE | ID: covidwho-2317111
ABSTRACT

Background:

The Cystic Fibrosis Foundation (CFF) advises that all persons with cystic fibrosis (PwCF) visit a cystic fibrosis (CF) care center every 3 months for evaluation, treatment, surveillance, counseling, and education [1]. In March 2020, our clinic went into modified operations in response to the COVID-19 pandemic, necessitating a temporary change in our ability to conduct routine face-to-face visits. Within 1 month, we operationalized virtual visits in addition to face-to-face visits. During the pandemic, staff noticed a drop in clinic attendance, and we implemented a quality improvement (QI) plan to study and address this trend. Method(s) Our QI team is a multidisciplinary group that is part of the Cystic Fibrosis Learning Network (CFLN). We defined the clinic fill rate (CFR) as the number of people seen over the number of available clinic slots. Each week, we determined the number of PwCF scheduled the following week and compared that number with no-shows and cancellations that occurred during that 7-day period. We also determined the number of PwCF scheduled 1 month ahead to compare it with weekly data. We used a key driver diagram to help focus our interventions (change ideas). Using run charts, we analyzed data each week to identify trends and variances. We used plan-do-study-act cycles and implemented initial interventions centered on publicizing CFF follow-up guidelines in town hall meetings, emails, and newsletters. We later identified PwCF who had a no-show history, and before clinics, our social worker communicated with each family (telephone or text) to remind them of the upcoming visit and identify any barriers to attending. During our study, Oregon experienced a surge in COVID-19 cases from the omicron variant, andwe overlaid our data with a graph of cases. Result(s) CFR was measured in 598 encounters over 28 weeks. CFR 1 month in advancewas 79%. In theweek before clinic, CFRwas 84%. After theweek, overall CFR was 66% (68% for face-to-face visits, 58% for virtual visits). Fifteen percent of our cancellations were COVID-related (increasing to 21% during the surge), but CFR did not change during the surge. After our intervention, those contacted in advance came to clinic 93% of the time, and our CFR improved to 74.8%. Conclusion(s) An 84% CFR, measured 1 week ahead of clinic, was dropping to an average of 66% because of late cancellations and no-shows, and widespread education about clinic attendance guidelines did not increase the rate. Having our social worker communicate directly with PwCF increased the overall CFR closer to our advance numbers, and 93% came to clinic. These communications also served as an additional patient interaction during which other social work needs were identified. Overall reduced clinic attendance may be related to the indirect impact of the pandemic and benefits of modulator therapy.We need to gather more postimplementation data and to consider different approaches to partnering with PwCF to achieve ideal follow-up.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved
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Texto completo: Disponible Colección: Bases de datos de organismos internacionales Base de datos: EMBASE Idioma: Inglés Revista: Journal of Cystic Fibrosis Año: 2022 Tipo del documento: Artículo

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Texto completo: Disponible Colección: Bases de datos de organismos internacionales Base de datos: EMBASE Idioma: Inglés Revista: Journal of Cystic Fibrosis Año: 2022 Tipo del documento: Artículo