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Completed 5 Ps

Toledo OneCF Center LLCProject: Improving Peds to Adult Transition

Improving Transition of CF patients from pediatric to adult

care

We aim to increase the number of combined pediatric/adult provider visits so that 25% of patients 18-21 years of age will have one combined visit by the end of 2014.

Improve Transition from Pediatric to Adult care

The process really begins with diagnosis and the first visit to our CF center and continues through adulthood. The scope of the current project, however, will focus on the process of transition from pediatric to adult provider which will begin at 18 years of age and be complete by 21 years of age. Our goal is improved patient care and patient satisfaction with the transition process.

1. A “transition worksheet” is placed in the patient’s chart. This facilitates recognizing that a patient is in the transition age range so that a combined visit can be discussed and then scheduled. The transition worksheet has a checklist of items to be discussed with the patient. It will also list the dates of the combined visits.2. A transition readiness assessment questionnaire was developed which is given to patient at age 18. This is used to provide education in needed areas.3. The worksheet and questionnaire are reviewed at team meetings so that providers are aware of the each patient’s progress

Several PDSA cycles have been used to figure out the best way to

manage the transition worksheets and readiness assessments (some PDSA cycles are in the following

slides). We are close to standardizing this process.

We are measuring the number of combined pediatric and adult visits using the transition worksheets. The data is entered into an excel spreadsheet (see following slide).***We have met our specific aim goal of having 25% of our patients having one combined visit***

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Fishbone

Fishbone diagram created to evaluate the process of inpatient admissions. This

is ongoing work (see following slide).

SDSA

PDSA Cycles

Measurement Combined Visits

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Number of Combined Visits

Number of Combined Peds/Adult Visits Linear (Number of Combined Peds/Adult Visits)Linear (Number of Combined Peds/Adult Visits)

Fishbone for Inpatient Admissions

• Ongoing evaluation of the inpatient admission process for patients 18 and older

• Education planned for inpatient staff