The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

DEVELOPMENT AND IMPLEMENTATION OF A PROCESS IMPROVEMENT PLAN FOR ALPHA-1 ANTITRYPSIN DEFICIENCY TARGETED SCREENING.

John S. Rinck, Jennifer Ely, Elaine Hurst; Pulmonary Diagnostics, Sparrow Hospital, Lansing, MI

BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is a genetic risk factor for pulmonary disease that often goes undiagnosed. Early diagnosis can improve patient outcomes by including preventive measures such as smoking cessation, monitoring, and appropriate therapy while lung function is still preserved. This report describes a three phase AATD testing and educational project instituted at our outpatient pulmonary function laboratory at Sparrow Health System in Lansing, Michigan between March and August 2011. METHOD: Phase I [Start up]: planning and development of an inexpensive, simple testing process that could easily be used in a primary care physician (PCP) setting. Phase II [PCP Education]: extending education and outreach to PCPs within the Sparrow network of hospital affiliations. Brochures were distributed to physician practices whenever AAT test results were mailed to the patientÂ’s PCP, providing guidance and education on epidemiology, genetics, diagnosis, and treatment. Lunch-and-learn sessions were provided to physicians at the satellite locations. Phase III [Sustainability and Penetration]: education and integration of AATD testing into 12 counties served by Sparrow Health System. RESULTS: Over 110 COPD patients were tested. Positive test results for AATD were processed with education material back to the patient and follow-up instructions guiding future care. Implementation of the protocol assured that there would be increased awareness and understanding of the meaning of test results. All physicians were notified of test results and received education (>90 in total). Outreach to all Sparrow affiliates is progressing. CONCLUSIONS: There are COPD patients who have pulmonary function studies performed but who may not receive complete treatment and follow up. The creation of a protocol to test, inform, educate, and treat patients who met ATS Guidelines for AATD testing became the focus of this endeavor. Implications for the Respiratory Care community: ease of testing, exposure to advanced pulmonology knowledge, an entry point for patient testing and follow up. Implications for patients: an informed COPD population, increased AATD knowledge, access to advanced counseling, treatment choices. Implications for PCPs: increased knowledge and awareness, application of evidence based medicine, exposure of undiagnosed or misdiagnosed pulmonary disease, treatment options, access to experts and treatment centers. Sponsored Research - None