Abstract
Background:
A polysomnogram (PSG) is the accepted standard for diagnosing sleep-related disorders of breathing. After the PSG is obtained the study is typically scored by a registered polysomnography technician or registered respiratory therapists with sleep specialty credential (RPSGT/RRT-SDS) using the American Academy of Sleep Medicine guidelines (AASM), then evaluated by a physician. For pediatric patients requiring a PSG there are often limitations where the study can be performed as well as who can score the pediatric PSG. In our pediatric facility, we aimed to reduce mean time to score (TTS) by RPSGT/RRT-SDS from 28 days in June 2021 (peak 41 days) using a stepwise goal-oriented approach in order to improve the patient turnaround time to results.
Methods:
In an IRB approved retrospective analysis, we reviewed PSG TTS from 1/1/2020-5/1/2022. In May of 2021 we instituted stepwise goals to the RPSGT team along with overall education of the goal and impact to patients and families served (Figure 1). We also added a score-from-home program to offer non-mandatory overtime to scoring team members in June of 2021. An additional 0.75 FTE was added to the budget in July 2021 to assist with staffing challenges related to scoring delays. We provided education to scorers from the RPSGT team in July of 2021 and set fixed output productivity goals for scorers in August of 2021 (goal of 4 studies scored in 12 hours). We tracked PSG TTS at monthly sleep lab meetings and daily on unit huddle boards for awareness and feedback from the team. The team members were provided rewards when goals were met and maintained.
Results:
3,236 pediatric PSG audits were reviewed; the age range of patients was newborn to 26 years (median 10.29 years). From January 2020 to April 2022 the sleep medicine team decreased the TTS from 28 days to 3 days (Graph 1).
Conclusions:
In our pediatric sleep labs, utilization of a step wise goal-orientated approach aided in reduction of PSG TTS from 41 in July 2021 to 3 days in May of 2022.
Figure 1 shows the stepwise goal-orienting approach to reducing the PSG TTS by RPSGT in our AASM certified Sleep Laboratories
View all access options for this article.Stepwise Goal-Oriented Approach to Decreasing PSG TTS
Goal/Step
Target TTS
Timeline
1
30 days
August 2021
2
20 days
October 2021
3
10 days
December 2021
4
7 days
February 2021
Final
3 days
April 2022
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