(78) Pre-visit planning initiative in partnership with pediatric Cystic Fibrosis patients and families

Background: Collaborative goal setting utilizing pre-visit planning (PVP) prior to clinic visits increases patient engagement, focuses discussion on topics meaningful to patients, and allows the patient to have more of a role in their treatment process [1]. The American Medical Association and published literature have shown that PVP leads to more effective clinic agenda setting, efficient delivery of care, and improved experience of care [2]. An updated PVP process that utilizes MyChart in the electronic medical record is one way to encourage patient communication prior to clinic visits and sustainably and resourcefully plan for a timely multidisciplinary CF clinic [3]. The aim of this initiative is to improve collaborative PVP for our patients and families in the Ann & Robert H. Lurie Children’s Hospital of Chicago CF Center. We expect to increase the percentage of patients contributing to PVP, develop more organization and structure for clinic visits, and co-produce clinic agendas with patients and families.

Methods: The body of the PVP message was developed into a smart phrase with patient/family and CF team member feedback. The message acts as an appointment reminder, informs of labs/x-rays that are due, what team members are due to see the patient, and topics the CF team wants to discuss during the visit. The message also asks patients/families to respond with what team members they would like to speak with and what questions/concerns they would like to discuss. Plan, Do, Study, Act (PDSA) cycles have been utilized during implementation, and adjustments to the process flow have been made based on patient/family and team member feedback. Measures include the number of PVP messages sent, percentage of messages read, percent of patients/families that reply, and average time nurses spend sending the messages each week.

Results: Approximately 180 patients are followed at our CF Center. Spanish is the primary language for 14% of families and MyChart is not yet active for this population. Approximately 80% of remaining families have active MyChart access. To date, collaborative PVP has been trialed with 33 patients and the goal is to fully implement with all families who have active MyChart prior to clinic by August 2022.

Conclusions: Currently the CF Center’s PVP process does not solidify an agenda with patient and healthcare team input, or save time in clinic for providers to address patient needs with resources and answers readily available [2]. Effective PVP can be used to cultivate skills in goal setting with healthcare professionals early to set pediatric patients up for success as adults [3].

Acknowledgements:

References: [1] Gholamzadeh, M., Abtahi, H., & Ghazisaeeidi, M. (2021). Applied techniques for putting pre-visit planning in clinical practice to empower patient-centered care in the pandemic era: a

systematic review and framework suggestion. BMC Health Services Research, 21(1), 458. https://doi.org/10.1186/s12913-021-06456-7

[2] Sinksy, C. A. (2019). Pre-visit planning: Save time and improve care. American Medical

Association. https://edhub.ama-assn.org/steps-forward/module/2702514



[3] Sleath, B., Carpenter, D., Davis, S., Watson, C., Lee, C., Loughlin, C. E., Garcia, N., Etheridge, D., Rivera-Duchesne, L., Reuland, D. S., Batey, K., Duchesne, C., & Tudor, G. (2017). Acceptance of a pre-visit intervention to engage teens in pediatric asthma visits. Patient Education and Counseling, 100(2017) 2005-2011. https://dx.doi.org/10.1016/j.pec.2017.05.013