Nutrition and Quality Improvement in Cystic Fibrosis

Part of the Nutrition and Health book series (NH)

Abstract

Quality improvement (QI) is a multidisciplinary method of understanding and improving the efficiency, effectiveness, and reliability of health processes and outcomes of care. Interest in quality improvement work in the field of CF has been increasing over the past decade. Aspects of the QI include patient registries, benchmarking projects, patient and family involvement, and care team education in improvement methods. Although nutrition related QI work has been implemented in many CF centers, there are few publications. Implementing nutrition QI projects using a standardized approach can potentially improve nutrition outcomes.

Keywords

Benchmarking Improvements Learning and Leadership Collaborative Nutrition Outcomes Patient registries Quality improvement 

References

  1. 1.
    McPheeters ML, Kripalani S, Peterson NB, Idowu RT, Jerome RN, Potter SA, Andrews JC. Closing the quality gap: revisiting the state of the science (vol. 3: quality improvement interventions to address health disparities). Evid Rep Technol Assess. 2012;208(3):1–475.Google Scholar
  2. 2.
    Berwick DM. The science of improvement. JAMA. 2008;12(299):1182–4.CrossRefGoogle Scholar
  3. 3.
    Stevens DP, Marshall BC. A decade of healthcare improvement in cystic fibrosis: lessons for other chronic diseases. BMJ Qual Saf. 2014;23 Suppl 1:i1–2.CrossRefPubMedGoogle Scholar
  4. 4.
    Kaplan HC, Brady PW, Dritz MC, et al. The influence of context on quality improvement success in healthcare: a systematic review of the literature. Milbank Q. 2010;88:500–59.PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    Crossing the quality chasm: a new health system for the 21st century: Institute of Medicine of the National Academies. National Academy Press: Washington, DC; 2001.Google Scholar
  6. 6.
    Schechter MS, Gutierrez HH. Improving the quality of care for patients with cystic fibrosis. Curr Opin Pediatr. 2010;22:296–301.CrossRefPubMedGoogle Scholar
  7. 7.
    Kraynack NC, McBride JT. Improving care at cystic fibrosis centers through quality improvement. Semin Respir Crit Care Med. 2009;30:547–58.CrossRefPubMedGoogle Scholar
  8. 8.
    Leonard A, Davis E, Rosenstein BJ, Zeitlin PL, et al. Description of a standardized nutrition classification plan and its relation to nutritional outcomes in children with cystic fibrosis. J Pediatr Psychol. 2010;35:6–13.CrossRefPubMedGoogle Scholar
  9. 9.
    Savant AP, Britton LJ, Petren K, et al. Sustained improvement in nutritional outcomes at two paediatric cystic fibrosis centres after quality improvement collaboratives. BMJ Qual Saf. 2014;23 Suppl 1:i81–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Siracusa CM, Weiland JL, Acton JD, et al. The impact of transforming healthcare delivery on cystic fibrosis outcomes: a decade of quality improvement at Cincinnati Children’s Hospital. BMJ Qual Saf. 2014;23 Suppl 1:i56–63.CrossRefPubMedGoogle Scholar
  11. 11.
    Yen EH, Quinton H, Borowitz D. Better nutritional status in early childhood is associated with improved clinical outcomes and survival in patients with cystic fibrosis. J Pediatr. 2013;162:530–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Cystic Fibrosis Foundation Patient Registry. 2012 annual data report. Bethesda, MD: Cystic Fibrosis Foundation; 2012.Google Scholar
  13. 13.
    Marshall BC, Nelson EC. Accelerating implementation of biomedical research advances: critical elements of a successful 10 year Cystic Fibrosis Foundation healthcare delivery improvement initiative. BMJ Qual Saf. 2014;23 Suppl 1:i95–103.CrossRefPubMedGoogle Scholar
  14. 14.
    Marshall BC, Penland CM, Hazle L, Ashlock M, Wetmore D, Campbell 3rd PW, Beall RJ. Cystic fibrosis foundation: achieving the mission. Respir Care. 2009;54:788–95. discussion 795.CrossRefPubMedGoogle Scholar
  15. 15.
    Borowitz D, Baker RD, Stallings V. Consensus report on nutrition for pediatric patients with cystic fibrosis. J Pediatr Gastroenterol Nutr. 2002;35:246–59.CrossRefPubMedGoogle Scholar
  16. 16.
    Stallings VA, Stark LJ, Robinson KA, et al. Clinical practice guidelines on growth and nutrition subcommittee. evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: results of a systematic review. J Am Diet Assoc. 2008;108:832–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Schechter MS, Fink AK, Homa K, et al. The cystic fibrosis foundation patient registry as a tool for use in quality improvement. BMJ Qual Saf. 2014;23 Suppl 1:i9–14.CrossRefPubMedGoogle Scholar
  18. 18.
    Stern M, Bertrand DP, Bignamini E, et al. European cystic fibrosis society standards of care: quality management in cystic fibrosis. J Cyst Fibros. 2014;13 Suppl 1:S43–59.CrossRefPubMedGoogle Scholar
  19. 19.
    Stern M. The use of a cystic fibrosis patient registry to assess outcomes and improve cystic fibrosis care in Germany. Curr Opin Pulm Med. 2011;17:473–7.PubMedGoogle Scholar
  20. 20.
    Wiedemann B, Steinkamp G, Sens B, et al. German cystic fibrosis quality assurance group. The German cystic fibrosis quality assurance project: clinical features in children and adults. Eur Respir J. 2001;17:1187–94.CrossRefPubMedGoogle Scholar
  21. 21.
    James BC. The cystic fibrosis improvement story: we count our successes in lives. BMJ Qual Saf. 2014;23:268–71.CrossRefPubMedGoogle Scholar
  22. 22.
    Sabadosa KA, Batalden PB. The interdependent roles of patients, families and professionals in cystic fibrosis: a system for the coproduction of healthcare and its improvement. BMJ Qual Saf. 2014;23 Suppl 1:i90–4.CrossRefPubMedGoogle Scholar
  23. 23.
    Warwick WJ, Pogue RE. Cystic fibrosis. An expanding challenge for internal medicine. JAMA. 1977;238:2159–62.CrossRefPubMedGoogle Scholar
  24. 24.
    Gutierrez HH, Sanchez I, Schidlow DV. Cystic fibrosis care in Chile. Curr Opin Pulm Med. 2009;15:632–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Antos NJ, Quintero DR, Walsh-Kelly CM, et al. Improving inpatient cystic fibrosis pulmonary exacerbation care: two success stories. BMJ Qual Saf. 2014;23 Suppl 1:i33–41.CrossRefPubMedGoogle Scholar
  26. 26.
    Corey M, McLaughlin FJ, Williams M, et al. A comparison of survival, growth, and pulmonary function in patients with cystic fibrosis in Boston and Toronto. J Clin Epidemiol. 1998;41:583–91.CrossRefGoogle Scholar
  27. 27.
    Boyle MP, Sabadosa KA, Quinton HB, et al. Key findings of the US cystic fibrosis foundation’s clinical practice benchmarking project. BMJ Qual Saf. 2014;23 Suppl 1:i15–22.CrossRefPubMedGoogle Scholar
  28. 28.
    Schechter MS. Benchmarking to improve the quality of cystic fibrosis care. Curr Opin Pulm Med. 2012;18:596–601.CrossRefPubMedGoogle Scholar
  29. 29.
    Britton LJ, Thrasher S, Gutierrez H. Creating a culture of improvement: experience of a pediatric cystic fibrosis center. J Nurs Care Qual. 2008;23:115–20.CrossRefPubMedGoogle Scholar
  30. 30.
    Godfrey MM, Oliver BJ. Accelerating the rate of improvement in cystic fibrosis care: contributions and insights of the learning and leadership collaborative. BMJ Qual Saf. 2014;23 Suppl 1:i23–32.CrossRefPubMedGoogle Scholar
  31. 31.
    Konstan MW, Butler SM, Wohl ME, et al. Investigators and coordinators of the epidemiologic study of cystic fibrosis. Growth and nutritional indexes in early life predict pulmonary function in cystic fibrosis. J Pediatr. 2003;142:624–30.CrossRefPubMedGoogle Scholar
  32. 32.
    McPhail GL, Acton JD, Fenchel MC, et al. Improvements in lung function outcomes in children with cystic fibrosis are associated with better nutrition, fewer chronic pseudomonas aeruginosa infections, and dornase alfa use. J Pediatr. 2008;153:752–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Steinkamp G, Wiedemann B. Relationship between nutritional status and lung function in cystic fibrosis: cross sectional and longitudinal analyses from the German CF quality assurance (CFQA) project. Thorax. 2002;57:596–601.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Ferkol T, Rosenfeld M, Milla CE. Cystic fibrosis pulmonary exacerbations. J Pediatr. 2006;148:259–64.CrossRefPubMedGoogle Scholar
  35. 35.
    Flume PA, Mogayzel Jr PJ, Robinson KA, et al. Clinical practice guidelines for pulmonary therapies committee. Cystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations. Am J Respir Crit Care Med. 2009;180:802–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Action guide for accelerating improvement in cystic fibrosis. Cystic Fibrosis Foundation version 1. 2006.Google Scholar
  37. 37.
    Tiddens HA. Quality improvement in your CF centre: taking care of care. J Cyst Fibros. 2009;8 Suppl 1:S2–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Berlinski A, Chambers MJ, Willis L, et al. Redesigning care to meet national recommendation of four or more yearly clinic visits in patients with cystic fibrosis. BMJ Qual Saf. 2014;23 Suppl 1:i42–9.CrossRefPubMedGoogle Scholar
  39. 39.
    Rayas MS, Willey-Courand DB, Lynch JL, et al. Improved screening for cystic fibrosis-related diabetes by an integrated care team using an algorithm. Pediatr Pulmonol. 2014;49:971–7.CrossRefPubMedGoogle Scholar
  40. 40.
    McDonald CM. Validation of a nutrition risk screening tool for children and adolescents with cystic fibrosis ages 2–20 years. J Pediatr Gastroenterol Nutr. 2008;46:438–46.CrossRefPubMedGoogle Scholar
  41. 41.
    Zanni RL, Sembrano EU, Du DT, et al. The impact of re-education of airway clearance techniques (REACT) on adherence and pulmonary function in patients with cystic fibrosis. BMJ Qual Saf. 2014;23 Suppl 1:i50–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Gastroenterology and NutritionThe Johns Hopkins Children’s CenterBaltimoreUSA

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