What You Need To Know
As part of our commitment to keeping the entire department informed, here is a brief update on the key initiatives and decisions from our February Pulmonology Specialty Collaborative meeting.
The goal of this collaborative is to bring physicians together to solve clinical challenges and standardize Pulmonology care across the network.
Key Updates from Our April Meeting
1. Refining the Network-Wide NIV Policy
The group held a productive working session to address a critical patient safety scenario within the new network-wide NIV policy.
- Transfers Between ICU-Level Units: The collaborative addressed the issue of unnecessary alerts firing when a patient on NIPPV is transferred between two ICU-level units while remaining under the care of an intensivist. The group aligned on implementing conditional alert suppression logic to prevent these alerts and reduce unnecessary consults.
2. Standardizing PFT Interpretation
In a major step towards improving diagnostic accuracy, the collaborative focused on standardizing PFT interpretation across the network.
- Adopting the 2022 ATS/ERS Guidelines: After reviewing current site capabilities and a presentation from a Pulmonology Chair, the collaborative formally agreed to adopt the 2022 ATS/ERS guidelines as the network standard. This includes the crucial shift to using race-neutral z-scores and GLI (Global Lung Function Initiative) equations for interpretation.
- Creating a Clinical Reference Tool: To support this transition, a reference sheet will be created for all reading pulmonologists. This document will summarize the key aspects of the new guidelines and will also be shared with Respiratory Therapy departments to ensure network-wide alignment.
3. Oxygen Ordering Standardization
Following a discussion on titration parameters, the collaborative formally approved the current build of the Oxygen Therapy order set. The group valued maintaining clinical flexibility for providers to set specific targets for different patient populations (e.g. CHF) over implementing rigid, hard-coded ranges.
4. Inpatient Thoracentesis Order Set
The collaborative reviewed a working draft of the inpatient Thoracentesis order set and, based on live feedback, added several new lab options, including amylase, cholesterol, and a Lymphoma profile panel/Flow Cytometry. Next steps include continuing to refine the inpatient order set and to begin working on a separate outpatient version.
Who to Contact
Do you have a clinical challenge, a workflow issue, or an idea for standardization? Please reach out to any of the Collaborative Chairs or the Network Patient Safety & Quality (PS&Q) Team: Jillian Stevens (jillian.stevens@hmhn.org) and Diveena Davis (diveena.davis@hmhn.org).
For any questions, please feel free to contact the Pulmonology Collaborative Chairs:
- Dr. Keith Brenner (keith.brenner@hmhn.org)
- Dr. Lisa Casale (lisa.casale@hmhn.org)
- Dr. Eric Costanzo (eric.costanzo@hmhn.org)
Thank you for your continued partnership in improving patient care.