title: Improving screening for diabetes in cystic fibrosis.
abstract: OBJECTIVE
  Annual screening for cystic fibrosis-related-diabetes (CFRD) using oral glucose tolerance test (OGTT) is recommended, but national testing rates are low. The purpose of this paper is to implement the quality improvement (QI) initiative to improve cystic fibrosis (CF) annual screening rates among patients at one CF center.
  
  
  METHODS
  To improve screening for CFRD at the CF Center, the authors used the Dartmouth Microsystem Improvement Ramp method and formed a collaborative working group. A process map was created to outline the steps and a fishbone analysis was performed to identify barriers and to utilize resources for implementing new interventions.
  
  
  RESULTS
  Prior to these interventions, 21 percent of eligible patients had completed annual screening and after the intervention, it rose to 72 percent. The initial completion rate with the first prescription was only 50 percent, but it improved steadily to 54/75 (72 percent) in response to reminder letters sent six weeks after the initial script was given.
  
  
  CONCLUSIONS
  Close tracking and reminder letters can improve adherence with annual OGTT screening for CFRD among CF patients, with special emphasis on high-risk patients.
  
  
  CONCLUSIONS
  There should be a special emphasis on screening for CFRD in high-risk CF patients (those with low BMI or higher age). This QI initiative brought about several operational changes in the annual OGTT screening process that have now become the standard operating procedure at the center.
authors.affiliation: Division of Pulmonary Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abdulhamid
authors.forename: Lokesh
authors.initials: L
authors.lastname: Guglani
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bouren
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Moltz
mesh_terms: D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008824:Michigan; D058996:Quality Improvement
keywords: Annual screening; Cystic fibrosis; Cystic fibrosis related diabetes; Oral glucose tolerance test; Quality improvement