The task of comparing outcomes between different CF Centers can be extremely difficult. Centers differ in the socio-economic make up of their patient population, geographical location, number of non-adherent patients, their level of aggressiveness in patient follow-up, insurance status, and patient population age distribution just to name a few. Atypical results in any of these factors can lead to a skewed assessment as to how well a center is doing. Additionally, there can be inherent variability in how centers perform on these and other variables – centers may perform more favorably in some factors or with certain types of patients. All of this makes determining how well a center is doing and how a center compares to others problematic.
However, it is possible to at least examine how a center performs on certain processes and outcomes and monitoring functions based upon published standards.
Flu Vaccination Rates
Flu vaccination continues to take a very high profile, especially among younger populations. Vaccines for the typical season flu are different. The Cystic Fibrosis Center of Chicago, as does The Centers for Disease Control (CDC), recommend that all children and adults who are high risk (e.g., those with cystic fibrosis) receive the flu vaccine each year. In spite of this, in a typical year, approximately only 60% of those with CF receive the flu vaccine. The Cystic Fibrosis Center of Chicago places a very high priority on ensuring that patients receive flu vaccines in order to reduce the impact of this preventable respirtory virus. We have set a standard of a 95% vaccination rate for the CF population. This is accomplished through aggressive tracking and documentation of vaccinations starting in September and ending in December. In 2013, 97% of patients with CF received the flu vaccine. This exceeds the national average as reported by the Cystic Fibrosis Foundation.
Numerous studies have shown that patients with CF who get more intensive monitoring have better outcomes. For those with CF, outcomes are strongly linked to
- More frequent office visits
- More sputum cultures and lab diagnostics
- Increased use of antibiotics
The Cystic Fibrosis Center of Chicago has developed a cutting edge computer tracking and monitoring system called PATS (Patient Analysis and Tracking System). PATS is a one of a kind system developed by Dr. Boas and is unique to The Cystic Fibrosis Center of Chicago and has been presented at the North American Cystic Fibrosis Conference. It has enabled The Cystic Fibrosis Center of Chicago to achieve superior patient outcomes which significantly exceed national averages.
Maintaining good nutrition is an important goal for the general population but an absolutely essential goal for those with cystic fibrosis. Likewise, if an individual with CF has any nutritional deficiencies, it is imperative that these be addressed for the maintenance of good health.
While many parameters are utilized to monitor nutritional status, body mass index (BMI) is a frequently used measure and one that is recommended by various Cystic Fibrosis organizations as an essential indicator of an individual’s nutritional level. BMI refers to a person’s height versus weight proportion. The Cystic Fibrosis Center of Chicago has developed a standard of BMI being at the 50th percentile or above.
The Cystic Fibrosis Center of Chicago current average BMI percentile at 51.5% is achieving national goals.
Lung Function Exceeds National Average
Lung function is one of the key indicators of health for those with cystic fibrosis. FEV1% reflects how well the airway's are open in terms of how much air is exhaled in one second. It is expressed as a percent of predicted based upon a person’s age, height, weight, and racial background.
Once again, The Cystic Fibrosis Center of Chicago’s average FEV1 percentile of 89.0%ile surpasses national goals.
The spread of infection and controlling the risk of infection in the hospital setting are of critical importance to anyone with cystic fibrosis. The Cystic Fibrosis Center of Chicago has taken a leadership role in developing and implementing aggressive hospital infection control policies. Likewise, our outpatient offices have undertaken their own aggressive measures to control the spread of infection.
Burkholderia cepacia represents one of the most problematic areas of infection control for those with CF. The Cystic Fibrosis Center of Chicago has implemented an aggressive program within all of our outpatient offices to minimize the risk of this infection. Our measures include:
- Computerized staggered scheduling
- Seeing patients with different infections on different day
- Utilization of hygiene wipes specific to kill B. cepacia in all common area surfaces and on equipment between patients
- Aggressive and frequent monitoring by sputum culture in nationally accredited microbiology labs with expertise in culturing B. cepacia
These measures have allowed The Cystic Fibrosis Center of Chicago to achieve good results.
The Cystic Fibrosis Center of Chicago has a minimal B. Cepacia infection rate of 1% which is about 1/3 the national rate of infection.
The Cystic Fibrosis Center of Chicago has significantly outperformed the national standard in outcome parameters reported by various Cystic Fibrosis organizations. We are dedicated to even further improving our excellent results and look forward to any feedback which will facilitate this endeavor.