Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Quality Improvement Intervention
2.3. Outcomes Measured
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Fellows’ Clinic, (n = 177) | Pre-Intervention Residents’ Clinic, (n = 451) | Post-Intervention Residents’ Clinic, (n = 119) | |
---|---|---|---|
Age, mean (SD) | 57.07 (8.23) | 58.9 (9.1) | 58.7 (8.6) |
Female, n (%) | 101 (57.06) * | 216 (47.9) | 55 (46.2) |
Physician-documented history of asthma, n (%) | 21 (11.86) | 63 (14.1) | 21 (17.7) |
Physician-documented history of congestive heart failure, n (%) | 28 (15.82) * | 104 (23.2) | 23 (19.3) |
FEV1/FVC, mean (SD) | 56.5 (16.2) * | 63.4 (15.6) | 60.1 (15.4) * |
FEV1, % predicted, mean (SD) | 54.8 (22.8) * | 64.2 (23.4) | 57.4 (23.1) * |
Total Lung Capacity, % predicted, mean (SD) | 97 (22.7) | 94 (21.7) | 102.3 (24.6) * |
Residual Volume, % predicted, mean (SD) | 128.4 (51.5) * | 116 (48.8) | 123.3 (48.2) |
Diffusion Capacity, % predicted, mean (SD) | 58.8 (20) * | 65.4 (21.3) | 66.5 (23.7) |
Use of short acting beta-agonist, n (%) | 158 (89.27) * | 396 (88) | 106 (89.1) |
Use of long acting beta-agonist, n (%) | 134 (75.71) * | 260 (57.8) | 75 (63) |
Use of inhaled corticosteroid, n (%) | 141 (79.66)* | 291 (64.7) | 79 (66.4) |
Use of long-acting muscarinic antagonist, n (%) | 92 (51.98)* | 162 (36) | 60 (50.4) * |
Active tobacco smoker, n (%) | 95 (54.9) | 252 (58.3) | 67 (56.3) |
Home oxygen, n (%) | 47 (26.2) * | 64 (14.2) | 21 (17.7) |
Patients seen by a pulmonologist in the year prior to index visit, n (%) | 177 (100) * | 70 (15.7) | 25 (21) |
Residents’ Clinic, (n = 451) | Fellows’ Clinic, (n = 177) | p Value | |
---|---|---|---|
Smoking cessation counseling documented, n (%) * | 206 (81.8) | 87 (91.6) | 0.024 |
Spirometry performed, n (%) | 300 (66.5) | 148 (83.6) | <0.001 |
Obstruction confirmed by spirometry, n (%) | 166 (36.8) | 109 (61.6) | <0.001 |
Pneumococcal vaccine, n (%) | 271 (61) | 110 (62.5) | 0.74 |
Pre-Intervention | Post-Intervention | p Value | |
---|---|---|---|
Spirometry performed, n (%) | 300 (66.5) | 89 (74.8) | 0.085 |
Smoking cessation counseling documented, n (%) * | 207 (81.8) | 58 (86.6) | 0.360 |
Pneumococcal vaccination, n (%) | 271 (61) | 86 (72.3) | 0.024 |
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Burkes, R.M.; Mkorombindo, T.; Chaddha, U.; Bhatt, A.; El-Kersh, K.; Cavallazzi, R.; Kubiak, N. Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic. Healthcare 2018, 6, 88. https://doi.org/10.3390/healthcare6030088
Burkes RM, Mkorombindo T, Chaddha U, Bhatt A, El-Kersh K, Cavallazzi R, Kubiak N. Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic. Healthcare. 2018; 6(3):88. https://doi.org/10.3390/healthcare6030088
Chicago/Turabian StyleBurkes, Robert M., Takudzwa Mkorombindo, Udit Chaddha, Alok Bhatt, Karim El-Kersh, Rodrigo Cavallazzi, and Nancy Kubiak. 2018. "Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic" Healthcare 6, no. 3: 88. https://doi.org/10.3390/healthcare6030088