Using Quality Improvement Science to Implement a Multidisciplinary Behavioral Intervention Targeting Pediatric Inpatient Airway Clearance

Ernst, Michelle M.; Wooldridge, Jamie L.; Conway, Edward M.; Dressman, Kathy; Weiland, Jeanne; Tucker, Karen; Seid, Michael

doi:10.1093/jpepsy/jsp013

Cited by 34 publications

(21 citation statements)

References 13 publications

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“…The clinical microsystem approach encourages partnering with patients and families (7)(8)(9)(10)(11). As illustrated in this project, seeking input from patients and families was invaluable.…”

Section: Role Of Patients Families and Parent Advisormentioning

confidence: 99%

“…In a second attempt to improve the quality of inpatient care for our patients with CF, we designed and implemented two quality initiatives using the clinical microsystem-based approach that has been applied successfully in outpatient pediatric CF settings (5)(6)(7).…”

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confidence: 99%

“…(5) Only 50% of staff on 5 North felt comfortable caring for patients with CF due to confusion about treatment modalities. (6) Only 50% staff felt they had the proper resources to care for patients with CF (7). The majority of healthcare workers on 5 North felt that patients with CF were too needy.Definition of abbreviations: CF = cystic fibrosis; PERT = pancreatic enzyme replacement therapy.…”

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confidence: 99%

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Application of a Microsystem-based Project to Improve the Inpatient Care of Adults with Cystic Fibrosis

Cohen¹,

Jaffrey²,

Fulman³

et al. 2013

Annals ATS

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Section: Role Of Patients Families and Parent Advisormentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Application of a Microsystem-based Project to Improve the Inpatient Care of Adults with Cystic Fibrosis

Cohen¹,

Jaffrey²,

Fulman³

et al. 2013

Annals ATS

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“…For older patients a multidisciplinary approach can increase airway clearance quantity and quality by 50%. 80 This approach, utilized by Ernst et al, involves allowing for patient selection of airwayclearance protocol, creating a reward system for the patient, and scheduling priority given to airway clearance. 80 …”

Section: Behavioral Issuesmentioning

confidence: 99%

Pediatric Airway Maintenance and Clearance in the Acute Care Setting: How To Stay Out of Trouble

2011

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1424RESPIRATORY CARE • SEPTEMBER 2011 VOL 56 NO 9Traditional airway maintenance and clearance therapy and principles of application are similar for neonates, children, and adults. Yet there are distinct differences in physiology and pathology between children and adults that limit the routine application of adult-derived airway-clearance techniques in children. This paper focuses on airway-clearance techniques and airway maintenance in the pediatric patient with acute respiratory disease, specifically, those used in the hospital environment, prevailing lung characteristics that may arise during exacerbations, and the differences in physiologic processes unique to infants and children. One of the staples of respiratory care has been chest physiotherapy and postural drainage. Many new airway clearance and maintenance techniques have evolved, but few have demonstrated true efficacy in the pediatric patient population. Much of this is probably due to the limited ability to assess outcome and/or choose a proper disease-specific or age-specific modality. Airway-clearance techniques consume a substantial amount of time and equipment. Available disease-specific evidence of airway-clearance techniques and airway maintenance will be discussed whenever possible. Unfortunately, more questions than answers remain.

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“…This increased commitment to assessing the biopsychosocial needs of the child and family is demonstrated in half of the 26 new ACA-mandated prevention screenings and services related to behavioral health [3]. There is considerable evidence for the value of psychologists in improving pediatric chronic care across a range of populations, service settings, referral concerns and behavioral, functional and biomedical outcomes [4][5][6][7][8][9]. Research examining the effectiveness of interprofessional care including psychologists has demonstrated improved biopsychosocial outcomes for both primary [10] and subspecialty integrated care [11,12].…”

Section: Introductionmentioning

confidence: 99%

Inter professional teamwork: A case study examining the practice patterns and perceptions of pediatric psychologists

Ernst¹,

Filigno²,

Byars³

et al. 2017

Contemp Behav Health Care

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Interprofessional care including psychologists has been shown to be effective for both primary and subspecialty integrated care. However, providers of behavioral health are infrequently included in studies of interprofessional collaborative practice. The current study explores the activities and perceptions related to interprofessional care of 13 psychologists involved in 19 different interprofessional teams within one institution. To fully explore relevant issues and examine barriers and facilitators to interprofessional teamwork in a systematic and comprehensive fashion, a mixed-method analytic design was used. Quantitative data were collected via survey. Qualitative data obtained by structured interviews were coded for critical themes using grounded theory. Pediatric psychologists working on interprofessional teams were generally satisfied with their experiences. Key facilitators included being valued on the team and using standardized assessments. Barriers centered on financial issues such as scheduling issues impeding billable activity. Based on these findings, we provide a number of recommendations on maximizing clinical care, optimizing the role within the interprofessional team and meeting professional responsibilities.

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Using Quality Improvement Science to Implement a Multidisciplinary Behavioral Intervention Targeting Pediatric Inpatient Airway Clearance

Abstract: A multidisciplinary, evidence-based intervention was effective for improving occurrence of best-practice ACT. Pediatric psychology can make valuable contributions to improving the quality of care provided in the medical setting.

Cited by 34 publications

References 13 publications

Application of a Microsystem-based Project to Improve the Inpatient Care of Adults with Cystic Fibrosis

Application of a Microsystem-based Project to Improve the Inpatient Care of Adults with Cystic Fibrosis

Pediatric Airway Maintenance and Clearance in the Acute Care Setting: How To Stay Out of Trouble

Inter professional teamwork: A case study examining the practice patterns and perceptions of pediatric psychologists

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