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The development of a community-based spirometry service in the Canterbury region of New Zealand: observations on new service delivery.

Epton MJ, Stanton JD, McGeoch GR, Shand BI, Swanney MP - NPJ Prim Care Respir Med (2015)

Bottom Line: These two organisations were responsible for organising training seminars and refresher courses on spirometry technique and interpretation of results.Although the service has proved to be more convenient for patients, the tests have not been delivered as quickly as those carried out by the Respiratory Physiology Laboratory.The success of the service has been dependent on several key factors including hospital and clinical support and a centralised quality assurance programme, a comprehensive training schedule and online clinical guidance and close integration between primary and secondary care clinicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Christchurch Hospital, Christchurch, New Zealand.

ABSTRACT
In 2008, as part of the changes to develop integrated health care services in the Canterbury region of New Zealand, the local health board in collaboration with general practitioners, respiratory specialists and scientists introduced a programme for general practices to provide laboratory-quality spirometry in the community. The service adhered to the 2005 ATS/ERS international spirometry standards. The spirometry service was provided by trained practice nurses and community respiratory nurses, and was monitored and quality assured by certified respiratory scientists in the Respiratory Physiology Laboratory, Christchurch Hospital and CISO (Canterbury Initiative Services Organisation). These two organisations were responsible for organising training seminars and refresher courses on spirometry technique and interpretation of results. A total of 10 practices have now become approved spirometry providers, with the number of tests carried out in the primary care setting increasing gradually. Consistently high-quality spirometry tests have been obtained and are now presented on a centrally available results database for all hospital and community clinicians to review. Although the service has proved to be more convenient for patients, the tests have not been delivered as quickly as those carried out by the Respiratory Physiology Laboratory. However, the time scales for testing achieved by the community service is considered suitable for investigation of chronic disease. The success of the service has been dependent on several key factors including hospital and clinical support and a centralised quality assurance programme, a comprehensive training schedule and online clinical guidance and close integration between primary and secondary care clinicians.

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Related in: MedlinePlus

Time-related changes in the number of spirometry tests carried out each month by either general practices or community respiratory nurses. The data are expressed as the mean of 3-month periods.
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fig1: Time-related changes in the number of spirometry tests carried out each month by either general practices or community respiratory nurses. The data are expressed as the mean of 3-month periods.

Mentions: There has been a gradual increase in total spirometry testing in community settings. In February 2011, there was a decrease in referrals, owing to the Christchurch earthquakes (Figure 1). After 2013, the number of tests undertaken by community respiratory nurses decreased, whereas tests undertaken in general practice increased. This was owing to a decision to increase Approved Provider practice numbers, to free up community respiratory nurse resources for other projects. The ratio of patients referred by another general practitioner for community-based spirometry to those who were registered patients of the approved provider was ~2:1 (64 vs. 36%). Overall, the number of spirometry tests provided in Canterbury has increased.


The development of a community-based spirometry service in the Canterbury region of New Zealand: observations on new service delivery.

Epton MJ, Stanton JD, McGeoch GR, Shand BI, Swanney MP - NPJ Prim Care Respir Med (2015)

Time-related changes in the number of spirometry tests carried out each month by either general practices or community respiratory nurses. The data are expressed as the mean of 3-month periods.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373496&req=5

fig1: Time-related changes in the number of spirometry tests carried out each month by either general practices or community respiratory nurses. The data are expressed as the mean of 3-month periods.
Mentions: There has been a gradual increase in total spirometry testing in community settings. In February 2011, there was a decrease in referrals, owing to the Christchurch earthquakes (Figure 1). After 2013, the number of tests undertaken by community respiratory nurses decreased, whereas tests undertaken in general practice increased. This was owing to a decision to increase Approved Provider practice numbers, to free up community respiratory nurse resources for other projects. The ratio of patients referred by another general practitioner for community-based spirometry to those who were registered patients of the approved provider was ~2:1 (64 vs. 36%). Overall, the number of spirometry tests provided in Canterbury has increased.

Bottom Line: These two organisations were responsible for organising training seminars and refresher courses on spirometry technique and interpretation of results.Although the service has proved to be more convenient for patients, the tests have not been delivered as quickly as those carried out by the Respiratory Physiology Laboratory.The success of the service has been dependent on several key factors including hospital and clinical support and a centralised quality assurance programme, a comprehensive training schedule and online clinical guidance and close integration between primary and secondary care clinicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Christchurch Hospital, Christchurch, New Zealand.

ABSTRACT
In 2008, as part of the changes to develop integrated health care services in the Canterbury region of New Zealand, the local health board in collaboration with general practitioners, respiratory specialists and scientists introduced a programme for general practices to provide laboratory-quality spirometry in the community. The service adhered to the 2005 ATS/ERS international spirometry standards. The spirometry service was provided by trained practice nurses and community respiratory nurses, and was monitored and quality assured by certified respiratory scientists in the Respiratory Physiology Laboratory, Christchurch Hospital and CISO (Canterbury Initiative Services Organisation). These two organisations were responsible for organising training seminars and refresher courses on spirometry technique and interpretation of results. A total of 10 practices have now become approved spirometry providers, with the number of tests carried out in the primary care setting increasing gradually. Consistently high-quality spirometry tests have been obtained and are now presented on a centrally available results database for all hospital and community clinicians to review. Although the service has proved to be more convenient for patients, the tests have not been delivered as quickly as those carried out by the Respiratory Physiology Laboratory. However, the time scales for testing achieved by the community service is considered suitable for investigation of chronic disease. The success of the service has been dependent on several key factors including hospital and clinical support and a centralised quality assurance programme, a comprehensive training schedule and online clinical guidance and close integration between primary and secondary care clinicians.

Show MeSH
Related in: MedlinePlus