The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

IMPROVING THE QUALITY OF BEDSIDE SPIROMETRY.

Edward Hoisington, RRT, Jamie Stoller, MD, Kevin McCarthy, RCPT Department of Pulmonary and Critical Care Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio 44195

BACKGROUND: A 1998 audit of spirometry tests done at our institution outside of the Pulmonary Function Laboratory revealed a low percentage (17%) of bedside spirometry tests meeting ATS acceptability and reproducibility criteria.

Methods: We initiated an improvement plan that included the following features:

1. Review of ATS acceptability and reproducibility criteria that was videotaped and made available to all therapists performing spirometry.

2. Limiting the number of operators to a ?core group? to allow more tests/therapist.

3. Availability of hardcopy printouts that allow review of volume-time and flow-volume curves.

4 Central review of all tests by a Pulmonary Function Technologist with constructive feedback on test quality, reproducibility and suggestions for improvement to the operators.

Results: Throughout the course of our review of spirometry tests, the overall percentage of tests judged to be acceptable and reproducible was 63.5%. This was significantly better than our initial audit (17% acceptable and reproducible, P=<0.001, Chi-square). FVC and FEV1 were reproducible in 75.9% of the testing sessions.

Conclusions: Our findings suggest that a quality improvement program for bedside spirometry testing that emphasizes a working knowledge of ATS acceptability criteria and review of tests with feedback on test quality can have positive measurable results.

OF-99-161

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