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Open AccessFeature PaperArticle

Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic

1
Department of Internal Medicine, University of Louisville, 550 S. Jackson Street, ACB 3rd Floor, Louisville, KY 40202, USA
2
Division of Pulmonary, Critical Care, and Sleep Medicine Disorders, Department of Internal Medicine, University of Louisville, 550 S. Jackson Street, Pulmonary, Critical Care and Sleep Disorders Medicine Offices, ACB 3rd Floor, Louisville, KY 40202, USA
3
Department of General Internal Medicine, University of Louisville, Palliative Care, and Medical Education, 550 S. Jackson Street, General Internal Medicine and Palliative Care Offices, ACB 3rd Floor, Louisville, KY 40202, USA
*
Author to whom correspondence should be addressed.
Healthcare 2018, 6(3), 88; https://doi.org/10.3390/healthcare6030088
Received: 25 May 2018 / Revised: 14 July 2018 / Accepted: 23 July 2018 / Published: 25 July 2018
(This article belongs to the Special Issue Chronic Obstructive Pulmonary Disease: Updates in Lung Health)
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Guideline-discordant care of COPD is not uncommon. Further, there is a push to incorporate quality improvement (QI) training into internal medicine (IM) residency curricula. This study compared quality of care of COPD patients in an IM residents’ clinic and a pulmonary fellows’ clinic and, subsequently, the results of a quality improvement program in the residents’ clinic. Pre-intervention rates of quality measure adherence were compared between the IM teaching clinic (n = 451) and pulmonary fellows’ clinic (n = 177). Patient encounters in the residents’ teaching clinic after quality improvement intervention (n = 119) were reviewed and compared with pre-intervention data. Prior to intervention, fellows were significantly more likely to offer smoking cessation counseling (p = 0.024) and document spirometry showing airway obstruction (p < 0.001). Smoking cessation counseling, pneumococcal vaccination, and diagnosis of COPD by spirometry were targets for QI. A single-cycle, resident-led QI project was initiated. After, residents numerically improved in the utilization of spirometry (66.5% vs. 74.8%) and smoking cessation counseling (81.8% vs. 86.6%), and significantly improved rates of pneumococcal vaccination (p = 0.024). One cycle of resident-led QI significantly improved the rates of pneumococcal vaccination, with numerical improvement in other areas of COPD care. View Full-Text
Keywords: pulmonary diseases; quality improvement; Medical Education; vaccinations; smoking cessation pulmonary diseases; quality improvement; Medical Education; vaccinations; smoking cessation
MDPI and ACS Style

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.

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