Patients' Opinion Regarding Length Of Stay For Cystic Fibrosis (CF) Pulmonary Exacerbations At A Single CF Center
INTRODUCTION: Intravenous (IV) antibiotics and intensified pulmonary clearance are the mainstay treatment for inpatient CF exacerbations. In 2015, our 4-day LOS was lower than the 10-day national average. Percent of treatment completed while inpatient (49%) and median FEV1 predicted (80.7%) were lower than the national 82.2% and 92.9% respectively.
OBJECTIVE: Our April 2017-2018 survey evaluated opinions regarding LOS to help identify improvement opportunities, with IRB exemption.
METHODS: Families received surveys during visits, and responses recorded in REDCap. Survey included demographics, number of hospitalizations, age, Likert-type items assessing perceptions on hospital LOS. Likert-type items were as follows: 1="Strongly Disagree", 2="Agree", 3="Neither agree nor disagree", 4="Agree", 5="Strongly agree". Frequency of responses and mean were calculated.
RESULTS: 19/35 families completed the survey. Most agreed that patients should remain hospitalized for most of the 14-day IV antibiotics course due to closer monitoring, prompt therapy adjustments and better outcomes. The negative associations with increased LOS: perceived increased infection exposure and decreased school performance. Most disagreed that hospitalizations decrease the stress of managing CFE and timeliness of treatments.
CONCLUSIONS: We wanted to identify intervention opportunities to improve perception of increased LOS. Although most patients agreed that longer stays result in improved outcomes, they worried about infection exposure and decreased school performance. Most disagreed that longer LOS leads to timelier therapy delivery and decreased stress. Next steps: working with staff to ensure timely treatments, patient education about infection control measures and minimization interruptions in school. In 2016, our already center showed improvement in those measures, reflecting changes.