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Abstract

Problem. The Pulmonary Function Test Time Project (PFT Project) is a quality improvement (QI) initiative designed to decrease PFT testing time and PFT total time in pediatric patients and improve the overall process for both providers and patients. Patients scheduled to see a pulmonary provider were also scheduled for a PFT prior to the provider’s visit. Data showed that the length of time to perform a pulmonary function test (PFT) was causing: (1) a delay in the pulmonary provider seeing patients at the intended appointment time, (2) a disruption to clinic workflow, resulting in scheduling difficulties, and (3) a decreased number of patients seen by the providers. Any delays with the PFT appointment could have a negative impact on the flow of clinic appointments. The aim of the PFT Project was to reduce the length of time for pulmonary function testing without compromising the quality of the test results.

Methods. The initiative applied a quality improvement approach using Plan, Do, Study, Act (PDSA) cycles to implement a change plan and achieve desired project outcomes. Monthly reports showing average PFT testing time, average PFT total time, and acceptability and repeatability (A/R) percent success rates were generated and utilized to discuss goal progress and to celebrate successes with the PFT lab team.

Results. 2973 patients were included in the procedure time portion of the initiative, and 4874 patients were included in the A/R percent success rate portion of the analysis. The average PFT testing time and average PFT total time were reduced by 49% and 24%, respectively, for spirometry. The average PFT testing time and average PFT total time for spirometry before and after administration of a bronchodilator (B&A BD) were reduced by 23% and 15%, respectively. There was an improvement in the acceptability and repeatability percent success rate within 22 months of initiating the project.

Conclusion. The implementation of improved PFT lab processes allowed us to meet the desired goal to decrease PFT testing time and PFT total time for both spirometry and spirometry B&A BD testing without negatively impacting quality.

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