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Education, Teaching, and Quality Improvement |

COPD Continuing Education Improves Quality in Clinical Practice FREE TO VIEW

Sandra Adams, MD; Mary Hart, RRT; Erika Bowen, MA; Leticia Bresnahan, MBA; Jan Patterson, MD
Author and Funding Information

UTHSCSA and STVHCS, San Antonio, TX


Chest. 2015;148(4_MeetingAbstracts):470A. doi:10.1378/chest.2270114
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Abstract

SESSION TITLE: Education, Research, and Quality Improvement

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 25, 2015 at 07:30 AM - 08:30 AM

PURPOSE: Post-bronchodilator spirometry is required for the diagnosis of COPD. Our local data from a University-based Primary Care Clinic (PCC) demonstrated that only 19% of patients with visit(s) to the PCC for COPD between 5/1/14 and 9/30/14 had undergone spirometry testing. The purpose of our interprofessional continuing education (CE) and quality improvement (QI) interventions was to change clinical practice by doubling the spirometry rates for COPD patients in the PCC in five months.

METHODS: We assembled an interprofessional team of healthcare professionals (HCP) and implemented PDSA (Plan Do Study Act) QI techniques as well as an interprofessional CE program entitled Web-based, Interactive Professional Education in COPD (WipeCOPD™). We assigned clinicians 1-1.5 hours of CE per month from the WipeCOPD™ program, which was accompanied by 30 minutes per month of “live” interactive, small group education by a COPD expert. We interviewed clinicians with high spirometry rates to determine how/why their rates were higher than average, providing insight into what was working well and we met HCP with low rates of ordering spirometry to discuss perceptions, barriers and potential solutions to this problem. The PCC bought spirometers and we trained the clinic support staff in proper techniques of performing spirometry by hands-on, small group and online education sessions. We added the following information technology reminder to the medical record: “Has your COPD patient ever had spirometry?” We collected follow-up data between 10/1/14 and 2/28/15.

RESULTS: Baseline COPD prevalence in the PCC was 3.8% and increased to 4.4% during the five months following the interventions, despite not implementing any case-finding questionnaires. Spirometry rates increased from 19% (14/75) in the initial period to 56% (176/312) during the five months of follow up after the interventions.

CONCLUSIONS: Interprofessional CE and QI interventions improved spirometry rates nearly three-fold for patients with COPD and improved the recognition of COPD by primary care clinicians. Despite not implementing screening questionnaires, the prevalence of COPD within the PCC significantly increased as well.

CLINICAL IMPLICATIONS: Interactive and high-quality continuing education and quality improvement interventions applied to primary care are associated with real clinical practice changes and these well-defined techniques may be disseminated to other practices as well.

DISCLOSURE: Sandra Adams: University grant monies: UT Patient Safety Grant, Grant monies (from sources other than industry): NIH, Grant monies (from sources other than industry): VA Cooperative Study, Grant monies (from industry related sources): AstraZeneca, Grant monies (from industry related sources): Boehringer Ingelheim, Grant monies (from industry related sources): GlaxoSmithKline, Grant monies (from industry related sources): Novartis Mary Hart: Grant monies (from industry related sources): GlaxoSmithKline, Grant monies (from sources other than industry): EPA, University grant monies: UTHSCSA Community Service Learning, Consultant fee, speaker bureau, advisory committee, etc.: Monaghan Medical Corp Erika Bowen: Grant monies (from industry related sources): GlaxoSmithKline Leticia Bresnahan: Grant monies (from industry related sources): GlaxoSmithKline Jan Patterson: Grant monies (from industry related sources): GlaxoSmithKline, Consultant fee, speaker bureau, advisory committee, etc.: Durata

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