Changes to a pediatric sleep disordered breathing clinic improve wait‐times and clinic efficiency. Issue 11 (1st May 2016)

• Record Type: Journal Article
• Authors: Lau, Amanda; Ewing, Chris; Gnanapragasam, Juanita; Majaesic, Carina; MacLean, Joanna; Mandhane, Piush J.
• Is Part Of: Pediatric pulmonology. Volume 51:Issue 11(2016:Nov.)
• Page Start: 1234
• Page End: 1241
• Publication Date: 2016-05-01
• Subjects: sleep medicine -- quality improvement; Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.23440
• Languages: English
• ISSNs: 8755-6863

Abstract

Summary: Background: Recognition of the impact of sleep disordered breathing (SDB) on health has increased referrals in pediatric respiratory medicine with a concomitant increase in wait‐times. Methods: To reduce wait‐time (primary outcome), we developed a rapid SDB clinic (RSC) to identify, diagnose, and treat patients with few to no comorbidities (uncomplicated) and presumed SDB based on the referral letter. The RSC uses 1) parent‐report questionnaires to capture the patients' medical history and 2) sleep testing (e.g., overnight oximetry) completed prior to the initial consultation. Results: The combination of pre‐clinic electronic‐questionnaires and testing increased patient consult capacity by 100%. Of the 256 patients referred to the RSC over 28 months, 130 patients were seen through the RSC, 17 patients were re‐triaged to a standard sleep clinic (SSC) after questionnaire review, 51 patients were completing the RSC process, and 75 patients had their referral cancelled. An electronic‐questionnaire RSC (n = 45) reduced wait‐times by 34% to 142.8 (SD 57) days compared to a paper‐questionnaire RSC ( P < 0.001). The electronic RSC was also associated with 77.4 (SD 74.1) days reduction in wait‐time ( P = 0.04) for SSC patients seen during the same timeframe. RSC patients were 75% less likely to require a follow‐up visit ( P < 0.001) compared to SSC patients seen during the same timeframe. Conclusion: A targeted, streamlined clinic using electronic‐questionnaires for uncomplicated patients can improve wait‐times for children being referred to pediatric respiratory medicine for evaluation of sleep disordered breathing.Pediatr Pulmonol. 2016;51:1234–1241. © 2016 Wiley Periodicals, Inc.