Original ArticleIndividualized daily schedules for hospitalized adolescents with cystic fibrosis
Section snippets
Schedule development and implementation
In October 2001, a team was formed to address the concerns of patients with CF hospitalized for a pulmonary exacerbation at Cincinnati Children's Hospital Medical Center. The team included the director of the adolescent unit to which many teens with CF are admitted, the CF Center director, a parent of two children with CF, and the CF clinical nurse specialist. Initially, the team planned to develop a patient pathway that would describe, in general, what happened during an inpatient admission.
Patient characteristics
Data from a total of 22 patients were examined. Seventeen patients completed the survey after using the individualized schedule. These data were compared with the data from five patients who declined to use the individualized schedule during the same period. The patients who chose to use the schedule were older (17.7 ± 3.4 vs 16.3 ± 2.4 years), slightly more likely to have private insurance (47% vs 40%), and less likely to be female (65% vs 100%) than were those who declined. All 22 patients
Discussion
The implementation of the individualized daily schedule for adolescents hospitalized for CF resulted in improved patient satisfaction while maintaining existing levels of therapeutic intervention. Although we had hoped to see a significant improvement in physical therapy, airway clearance, and school attendance, we were pleased that using the individualized daily schedule did not lead to a decline in therapies received.
Adolescents hospitalized for a pulmonary exacerbation face many challenges
Acknowledgements
We thank Jim Lang, Kathy Dressman, Debbie Warden, James Acton, and Terri Schindler for their help in completing this project.
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Evidence for family-centered care for children with special health care needs: A systematic review
2011, Academic PediatricsCitation Excerpt :A family-centered, school-based behavioral intervention for children with inattentive and disruptive behavior problems also showed FCC activity was associated with improved child health status, with 3 of 21 symptom severity and function outcomes statistically significantly improved and 19 trending in the right direction.19 In assessing a team approach to cystic fibrosis treatment in the hospital, Weiland and colleagues found no difference in airway clearance.20 An assessment of perceptions of family-provider relationships for children with Down syndrome found better overall parental psychological well-being but no differences in parental depression measures.21
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2006, Joint Commission Journal on Quality and Patient SafetyCitation Excerpt :Table 3 (above) shows examples of measures that link to these aims and related improvement projects. Projects have entailed, for example, using evidence-based point-of-care instruments to reduce unwarranted treatment variation,31 engaging hospitalized adolescents with cystic fibrosis in the design of their individualized daily schedule to improve satisfaction,32 and using statistical process control to manage calcineurin inhibitor blood levels in liver transplant recipients, resulting in a doubling of the proportion of blood levels in the desired range.33 The key factors contributing to our ongoing transformation journey include senior leadership focus and drive for change, perfection or near-perfection goals, vertical alignment in measures, accountability, improvement capability, commitment to internal and external transparency, focus on measurement, and constancy of purpose.
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- 1
Jeanne Weiland, RN, MSN, CPNP, is a Clinical Nurse Specialist at the Division of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
- 2
Pamela J. Schoettker, MS, is a Medical Writer at the Center for Health Policy & Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
- 3
Terri Byczkowski, PhD, is a Research Associate at the Center for Health Policy & Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
- 4
Maria T. Britto, MD, MPH, is an Associate Professor of Pediatrics and Internal Medicine at the Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
- 5
Gerry Pandzik, RN, is an Organizational Development Administrator at the Division of Patient Services, Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
- 6
Uma R. Kotagal, MBBS, MSc, is Vice President of Quality and Transformation and the Director of the Center for Health Policy and Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.