Improving screening for diabetes in cystic fibrosis
Improving screening for diabetes in cystic fibrosis
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DOI：
10.1108/ijhcqa-05-2014-0059
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发表时间：
2015-01-01
影响因子：
1.5
通讯作者：
Moltz, Kathleen C.
中科院分区：
文献类型：
--
作者：
Abdulhamid, Ibrahim;Guglani, Lokesh;Moltz, Kathleen C.
目的：建议每年使用口服葡萄糖耐量试验（OGTT）筛查囊性纤维化相关糖尿病（CFRD），但全国的检测率较低。本文的目的是实施质量改进（QI）计划，以提高一个囊性纤维化（CF）中心患者的囊性纤维化（CF）年度筛查率。设计/方法/途径-为了改善CF中心的CFRD筛查，作者使用了达特茅斯微系统改进斜坡方法并成立了一个协作工作组。创建了一个过程图，概述了步骤和鱼骨分析进行识别障碍，并利用资源实施新的interventions.Findings -在这些干预措施之前，21%的合格患者完成了年度筛查和干预后，它上升到72%。第一个处方的初始完成率只有50%，但它稳步提高到54/75（72%）在回应提醒信发送后六个星期的初步脚本given.Practical影响-密切跟踪和提醒信可以提高遵守每年OGTT筛查CFRD CF患者，特别强调高风险患者。独创性/价值-应特别强调在高风险CF患者（低BMI或更高年龄）的CFRD筛查。这一QI计划为年度OGTT筛选流程带来了几项操作上的变化，这些变化现在已成为该中心的标准操作程序。
Purpose - Annual screening for cystic fibrosis-related-diabetes (CFRD) using oral glucose tolerance test (OGTT) is recommended, but national testing rates are low. The purpose of this paper is to implement the quality improvement (QI) initiative to improve cystic fibrosis (CF) annual screening rates among patients at one CF center.Design/methodology/approach - To improve screening for CFRD at the CF Center, the authors used the Dartmouth Microsystem Improvement Ramp method and formed a collaborative working group. A process map was created to outline the steps and a fishbone analysis was performed to identify barriers and to utilize resources for implementing new interventions.Findings - Prior to these interventions, 21 percent of eligible patients had completed annual screening and after the intervention, it rose to 72 percent. The initial completion rate with the first prescription was only 50 percent, but it improved steadily to 54/75 (72 percent) in response to reminder letters sent six weeks after the initial script was given.Practical implications - Close tracking and reminder letters can improve adherence with annual OGTT screening for CFRD among CF patients, with special emphasis on high-risk patients.Originality/value - There should be a special emphasis on screening for CFRD in high-risk CF patients (those with low BMI or higher age). This QI initiative brought about several operational changes in the annual OGTT screening process that have now become the standard operating procedure at the center.