Cystic fibrosis learning network telehealth innovation lab during the COVID-19 pandemic: a success QI story for interdisciplinary care and agenda setting

IntroductionThe Cystic Fibrosis Foundation chronic care guidelines recommend monitoring clinical status of a patient with cystic fibrosis (CF) through quarterly interdisciplinary visits. At the beginning of the COVID-19 pandemic, the Cystic Fibrosis Learning Network (CFLN) designed and initiated a t...

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Published in:	BMJ open quality Vol. 11; no. 2; p. e001844
Main Authors:	Albon, Dana, Thomas, Lacrecia, Hoberg, Lindsay, Stamper, Sophia, Somerville, Lindsay, Varghese, Prigi, Balasa, Ella, Roman, Matthew, Britto, Maria T, Miner, Melanie, Gehring, Emily, Gammon, Clifford, Amin, Raouf S, Seid, Michael, Powers, Mike, Daines, Cori, Drake, Glenda, Mees, Lilly, Sharpe, Amanda, Gordon, Rachel, Murphy, Lucinda, Uluer, Ahmet, McMahon, Lindsey, Abdelnour, Melanie, Murray, Meghan, Sathe, Meghana, Sharma, Preeti, Liberto, Traci, Linnemann, Rachel, Schiff, Sydney, Tucker, Heather, Tirakitsoontorn, Pornchai, Sou, Maivy, Maciel, Alicia, Schechter, Michael, Molzhon, Andrea, Antos, Nicholas, Brueck, Nicole, Wunschel, Karen, Siracusa, Christopher M, Mullen, Lisa A, Traver, Kyle, Gifford, Alex, Felicetti, Nicola, Dolan, Heidi, Gendreau, Tracey, Beachler, Danielle, Pai, Shine-Ann, Robbins, Stephanie, Orcutt, Zoe, McCullar, Ben, Deveaux, Lindsaey, Merlo, Christian, Mitchell, Lauren, Scaljon, Andrew, Brown, Rebekah, Rushing, Stefanie, Birnbaum, Virginia, Sadeghi, Hossein, Raissi, Golnar, Corcoran, Bean, Prickett, Michelle, Nelson, Rachel, Cullina, Joanne, Asfour, Fadi, Snuggerud, Anne, Ong, Thida, Gorry, Sabrina, Greene, Lisa, Michelson, Peter, Renschen, Sara, Price, Mike, Price, Betsy, Kier, Catherine, Corr, Sandy, Leyva, Barbara, Salvatore, Jillian, Solomon, George M, Bailey, Julianna, Nasr, Samya Z, Raines, Rebekah, Enochs, Catherine, Dunitz, Jordan, Jesse, Kristen, Warner, Kayla, Flath, Jonathan, Wharram, Mackenzie, Froh, Deborah, Carroll-Owens, Holly, List, Rhonda, Williamson, Lauren, Tolle, James, Eastman, Susan, Benchea, Marrisa, Chaudary, Nauman, Farsad, Mahsa, Wingo, Kimberly, Moffett, Kathryn, Brozik, Erin, Huffman, Jillian
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 01-05-2022 BMJ Publishing Group LTD BMJ Publishing Group
Subjects:	Coronaviruses COVID-19 Cystic fibrosis Failure Modes and Effects Analysis (FMEA) Interdisciplinary aspects Pandemics PDSA Quality improvement Quality Improvement Report Teamwork Telemedicine United States > US COVID-19 Quality improvement Teamwork Failure Modes and Effects Analysis (FMEA) PDSA
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Summary:	IntroductionThe Cystic Fibrosis Foundation chronic care guidelines recommend monitoring clinical status of a patient with cystic fibrosis (CF) through quarterly interdisciplinary visits. At the beginning of the COVID-19 pandemic, the Cystic Fibrosis Learning Network (CFLN) designed and initiated a telehealth (TH) innovation lab (TH ILab) to support transition from the classic CF care model of quarterly in-person office visits to a care model that included TH.AimThe specific aims of the TH ILab were to increase the percentage of virtual visits with interdisciplinary care (IDC) from 60% to 85% and increase the percentage of virtual visits in which patients and families participated in shared agenda setting (AS) from 52% to 85% by 31 December 2020.MethodsThe model for improvement methodology was used to determine the ILab aims, theory, interventions and measures. In the testing phase of the ILab, data related to process and outcome measures as well as learnings from plan–do–study–act cycles were collected, analysed and shared weekly with the TH ILab teams. Participating centres created processes for IDC and AS for TH visits and developed and shared quality improvement tools specific to their local context with other centres during the ILab weekly meetings and via a secure CFLN-maintained platform.ResultsBoth specific aims were achieved ahead of the expected target date. By August 2020, 85% of the TH ILab visits provided IDC and 92% of patients were seen for CF care by teams from the TH ILab that participated in AS.ConclusionShared learning through a collaborative, data-driven process in the CFLN TH ILab rapidly led to standardised TH IDC and AS, which achieved reliable and sustainable processes which could be reproduced by other networks.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2399-6641 2399-6641
DOI:	10.1136/bmjoq-2022-001844