Increasing efficiency in evaluation of chronic cough

A multidisciplinary, collaborative approach

Cynthia M. Patton, Kaiser G. Lim, Luke W. Ramlow, Kathleen M White

Research output: Contribution to journalArticle

Abstract

Chronic cough is the most common reason for medical office visits in the United States. The typical patient has coughed more than 8 years and seen many specialists. This quality improvement project is an ambulatory clinic redesign to deliver efficient, patient-centered care with interspecialty collaboration. Methodology included the Institute for Healthcare Improvement collaborative model focused on Lean/Six Sigma and ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) Change Management. Interventions targeted education to referring providers, implementation of software changes, building a collaborative interdepartmental scheduling decision tree, and an interclinic dashboard enhancing communication and decision support. Outcome measures compare group resource utilization, evidenced by the total number of specialist referrals for same indication of chronic cough (International Classification of Diseases, Ninth Revision: 786.2), and length of time to complete evaluation. A retrospective review of 165 medical records yielded 2 groups, "current care" (n = 67) and "intervention" (n = 68). The number of specialist referrals per patient was reduced in the intervention group (M = 1.22, SD = 0.48) compared with the current care group (M = 3.33, SD = 1.02). Length of itinerary was reduced in the intervention group (M = 11.90, SD = 12.13, GM = 6.82) compared with the current care group (M = 126.93, SD = 158.13, GM = 54.8). Multidisciplinary collaboration, communication, coordinating diagnosis, and management of multifactorial conditions, such as chronic cough, are associated with lower costs and decreased utilization of health care resources.

Original languageEnglish (US)
Pages (from-to)177-182
Number of pages6
JournalQuality Management in Health Care
Volume24
Issue number4
DOIs
StatePublished - Nov 11 2015

Fingerprint

Cough
Efficiency
efficiency
Referral and Consultation
Interdisciplinary Communication
evaluation
Total Quality Management
Office Visits
Patient-Centered Care
Decision Trees
Aptitude
Group
Health Resources
International Classification of Diseases
Quality Improvement
Medical Records
Software
utilization
Communication
Outcome Assessment (Health Care)

Keywords

  • Chronic cough
  • Collaboration
  • Lean
  • Six Sigma
  • Specialist referral

ASJC Scopus subject areas

  • Health Policy
  • Care Planning
  • Health(social science)
  • Leadership and Management

Cite this

Increasing efficiency in evaluation of chronic cough : A multidisciplinary, collaborative approach. / Patton, Cynthia M.; Lim, Kaiser G.; Ramlow, Luke W.; White, Kathleen M.

In: Quality Management in Health Care, Vol. 24, No. 4, 11.11.2015, p. 177-182.

Research output: Contribution to journalArticle

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