RT Journal
A1 McPhail GL, Weiland J, Acton JD, et al
T1 IMproving evidence-based care in cystic fibrosis through quality improvement
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD October 1
VO 164
IS 10
SP 957
OP 960
DO 10.1001/archpediatrics.2010.178
UL http://dx.doi.org/10.1001/archpediatrics.2010.178
AB Objective 
    To increase clinician adherence to prescribing guidelines for pulmonary medications in children with cystic fibrosis (CF).Design 
    Quality improvement project with multiple time series design.Setting 
    The CF center at a tertiary care pediatric hospital in the United States.Patients 
    Children with CF who were eligible to receive oral azithromycin, nebulized dornase alfa, or inhaled tobramycin sulfate based on prescribing guidelines for CF lung disease.Intervention 
    Evidence-based prescribing guidelines were designed by a local committee to reflect consensus recommendations from the CF Foundation. Clinicians and families were educated about guidelines. Adherence to prescribing guidelines was tracked using a local CF database and record reviews. Weekly meetings were used to highlight adherence failures and promote clinician accountability.Main Outcome Measure 
    The rate of clinician adherence to prescribing guidelines.Results 
    One hundred seventy patients with CF were included. At the start of the project, the rate of clinician adherence to prescribing guidelines was 62%. After 3 months of the project, the rate of clinician adherence to prescribing guidelines was 87% (odds ratio = 4.6; 95% confidence interval, 3.0-7.0). The improvements in adherence to prescribing guidelines were sustained for 21 months of follow-up.Conclusions 
    Educating clinicians about prescribing guidelines, sharing guidelines with families, and monitoring clinician adherence improve prescribing adherence to evidence-based recommendations.