(304) Utilizing Network Learning Models to Facilitate Best Practices for Successful Conversations Prompted from the Daily Care Check-In

Background: In managing their daily care, people with CF/caregivers (p/cCF) can face significant barriers to complete their complex, time-consuming regimen. Discussion of these barriers between p/cCF and their CF team pose their own set of challenges, including: fear of judgement or disappointment, lack of common language, embarrassment, and feelings of isolation. The Daily Care Check-In (DCC) is a previously validated measure of barriers and can be used to facilitate these conversations in a productive way. Network learning models have been shown to be effective in large-scale implementation using quality improvement (QI). The CF Learning Network (CFLN) and Success with Therapies Research Consortium (STRC) have partnered to lead an effort to test implementation strategies across sites and develop best practices to address barriers elicited from the DCC.

Methods: The STRC and CFLN collaborated to implement a two-phase ‘challenge’. Phase 1 (described in a separate QI abstract) focused on using QI methodology to implement DCC in clinical practice. Phase 2 tested interventions designed to trigger successful conversations around barriers prompted from the DCC. The Phase 2 ‘kick-off’ included a presentation from the CFF ‘Partnership Enhancement Program’ (PEP). Teams of key stakeholders were surveyed on their training/expertise of communication strategies and invited to develop a common definition of ‘successful conversations.” Teams were challenged to use QI methodology to practice, iterate, and ultimately measure frequency of successful conversations. Learnings were shared among teams during bi-weekly virtual study meetings. Pre- and post- surveys were collected from team members around their capacity to address specific, DCC-elicited concerns, comfort discussing specific topics, and subjective feedback.

Results: Five CF Programs (adult and pediatric), all members of the STRC and CFLN, participated in both phases of this challenge. Across all programs, 25 stakeholders responded to the pre-study survey. Most respondents disclosed prior formal communication training. Team member’s capacity to address p/cCF-elicited concerns are outlined in table 1. Comfort discussing DCC topics with p/cCF varied from 'not at all' comfortable, to 'extremely' comfortable - with most respondents answering 'somewhat' or 'very' comfortable. Post-surveys will be distributed at the end of the challenge. Common definition of a ‘successful conversation’ was coproduced as meeting three core components: ‘feeling heard’, ‘listening and exploring to learn more’, and ‘coproduction of a plan/follow-up, if applicable.’ Post-survey data and other measures will be obtained and presented after study completion.

Conclusions: Use of the DCC in clinical CF care facilitates identifying p/cCF barriers to daily care and is prompting teams to lean into relationship-centered communication skills to coproduce solutions with p/wCF.

Acknowledgements: This study was funded, in part, by the CFLN (SEID19ABO), CFLN site-grants, and STRC DMC grant (RIEKER15PE0).

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