2011 OPEN FORUM Abstracts
PAP THERAPY: INCREASING PATIENT COMPLIANCE THROUGH CLINICAL DRIVEN PATHWAYS.
Jenni Beilman, Becky Hall, Debbie Schuessler; Respiratory Care, Via Christi Home Medical, Wichita, KS
Background: In 2006, based on a health system wide initiative to increase our focus on clinical outcomes, the business decision was made to utilize only PAP devices that provide clinical data download capabilities. To achieve a more acceptable compliance rate, we believed a clinically driven pathway was required. The recognized national home care industry average for PAP compliance was approximately 40 to 50%. Third party payers are beginning to recognize the significance of compliance for overall health benefits. In November 2008 Medicare implemented guidelines focusing on more stringent PAP compliance requirements. Objective: In order to maximize PAP compliance, a clinically driven therapy pathway was developed and implemented which allowed individualized education and support with a respiratory therapist. Method: The pathway was implemented for all new PAP therapy patients and provided education and follow-up on a planned schedule to allow therapists to monitor the patient's symptoms and clinical data. This clinical supervision, along with wireless modems and data card downloads, allowed for close monitoring during the first 30 days which is widely recognized as the critical window to enable the patient to be successful with therapy. A therapist contacts the patient at a minimum of 24-48hr, 2 week, 30 day, 60 day, 90 day, 6 months. At each of these follow ups, a subjective patient interview as well as a review of the clinical data is done to determine the patient's response to therapy. We utilized the Respironics Encore Software Program to track and monitor our patients. Our clinical and compliance outcomes were derived by this program. Results: Since monitoring compliance, our PAP compliance percentile has risen from 62% to a current level of 83.7%. This represents an increase of 21.7%, and an increase by home care industry average of 38.7%. Conclusion: It was hypothesized that PAP compliance would be optimized when patients were followed via a therapist driven clinical pathway which allows for intensive intervention and oversight. Compliance rates were monitored over a period of 5 years and it was determined that they exceeded the national rate for PAP compliance by an average of 30% to 50%. References are available.
Sponsored Research - None
Compliance Average by Year