Pulmonology Commons^™

Identifying Unnecessary And Excessive Use Of Intravenous Heparin For The Treatment Of Intermediate-Risk Pulmonary Embolism, Youssef Elfatatry, Ryan Gardner, Chukwuemezie Kamanu, Ruben Rhoades

Health Equity and Quality Improvement (HEQI) Summit

Problem Statement

- Intermediate-risk pulmonary embolism (PE) is a diagnosis with heterogenous presentations and mortality rates ranging from 2% to 15%.

- European Society of Cardiology (ESC) guidelines recommend low-molecular weight heparin (LMWH) as first line therapy in most patients. Despite this, the use of IV heparin in intermediate-risk PE remains widespread, due to uncertainty regarding patients receiving further procedures and mitigation of bleeding risk.

Project AIM:

- We aim to (1) identify prescribing patterns and outcomes of anticoagulant therapy on admission, and (2) propose and implement a "PE Care Pathway" in EPIC to address uncertainty in risk-stratifying and treating …

A Multidisciplinary Intervention To Improve Acute Respiratory Distress Syndrome (Ards) Recognition In The Intensive Care Unit, Julia G. Katcher, M. Schaffer, Bridget Gekas, Jeffrey Riggio, Erika J. Yoo, Michael Baram

Health Equity and Quality Improvement (HEQI) Summit

Background

• ARDS is underrecognized, undertreated, and associated with a high mortality rate.¹
• Previous chart review in 2017 of 137 Jefferson MICU patients with acute respiratory failure revealed poor adherence to ARDS recommendations and protocols within first 24 hours.
• Respiratory therapist-driven protocols have been shown to increase adherence to lung-protective ventilation.²
• Frequent evaluation of ventilat0r settings and patient response is a cornerstone of early ARDS management.³

The Utility Of The Pap Nap For Increasing Patient Utilization Of Positive Airway Pressure Therapy, Erin Creighton, Md, Nicole Molin, Md, Dimitri Markov, Md, Ritu Grewal, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

• An estimated 9-38% of adults have obstructive sleep apnea (OSA), and about 80% is undiagnosed.
• OSA has been linked to excessive sleepiness, neurocognitive impairments, reduced quality of life, diabetes, heart disease, stroke, hypertension, and motor vehicle and workplace accidents
• Approximately85% of people with diagnosed OSA receive PAP and only 35-60% remain compliant long term
• Many factors impact CPAP use: disease and patient characteristics, titration procedures, device factors, side effects, psychological and social factors

Project AIM: Evaluate whether a daytime, abbreviated cardio-respiratory sleep study (AKA the PAP NAP -developed to help improve adherence in patients with OSA and …

Improving The Use Of Asthma Action Plans, Pooja Pandit, Md, Aaron B. Kaye, Md, Hassan Shahid, Md, Colin Peters, Do, Jessica Most, Md

Health Equity and Quality Improvement (HEQI) Summit

Objectives

• Identify the percentage of asthmatics in Friday fellows’ clinic with an AAP in place.
• Determine if clinician education can increase the number of AAP created for patients.

Quality Of Post-Discharge Follow-Up In Patients Admitted To Tjuh With Intermediate High Risk Pulmonary Embolism, D. Kramer, P. Kirupaharan, M. Flamenbaum, M. Scharf

Health Equity and Quality Improvement (HEQI) Summit

• Our institution has developed a multidisciplinary pulmonary embolism response team (PERT) to help in the management of patients with intermediate high risk pulmonary embolism
• While the PERT focus is on acute inpatient management, it is important that PERT patients have close follow-up to monitor for known future complications including thromboembolic pulmonary hypertension (CTEPH) and chronic pulmonary embolism syndrome
• CTEPH, in particular, is a potentially treatable disease with significant morbidity if left untreated
• Therefore, an underappreciated and important aspect of the PERT team should be the coordinated follow-up and long term care of these patients
• We wanted to better understand how …

Incidental Findings On Ldct For Lung Cancer Screening: Prevalence And Clinical Management, Chris Mcgrath, Md, Mrinalini Venkata-Subramani, Md, Brandon Menachem, Md, Amry Majeed, Brooke Ruane, Crnp, Christine Shusted, Mph, Julie Barta, Md

Health Equity and Quality Improvement (HEQI) Summit

Objectives

• To define the frequency of incidental findings on low-dose CT (LDCT) scans among patients undergoing lung cancer screening.
• To determine the current reporting methods for incidental findings and measure the frequency of clinical follow-up.

Standardized Bronchoscopy Testing For Immunocompromised Patients, C. Nieweld, A. Gandler, K. Biblowitz, B. Menachem, J. Most

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

• Determine the consistency in which the order set was followed
• Determine the length of time from finding pulmonary infiltrate to consultation
• Determine the length of time from consultation to bronchoscopy
• Determine whether a follow up note was written by pulmonary
• Determine whether management is affected based on obtained results

Exploring The Effectiveness Of Asthma Action Plans In Long-Term Asthma Management, Pankhuri Jha, Jessica Most, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

• Determine the efficacy of AAP in helping patients feel more confident in their self-management
• Improve asthma control by at least 10% after receiving an Asthma Action Plan