Sleep clinic solves mystery behind repeat studies

UBT teams up with equipment manufacturer to improve accuracy

WEDNESDAY, DECEMBER 7, 2011 :: By Jennifer Gladwell

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Management co-lead(s)

Chad McGlothlin,Chad.L.McGlothlin@kp.org, 720-536-6718

Union co-lead(s)

Patty Carter,Patricia.L.Carter@kp.org,303-764-4469

Supervisor Chad McGlothlin demonstrates the sleep apnea machine with the improved clasps.

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When the sleep apnea team at Skyline Medical Office in Colorado thought about improving service, it knew exactly where to focus—on reducing the number of repeat sleep studies. Team members’ efforts led them beyond the clinic walls to the company that manufactures the equipment used to conduct the studies to improve the design.

The team was repeating 30 sleep studies a month, out of a case load of about 70, with a backlog of a thousand patients waiting to get onto the schedule.

“Patients were annoyed they couldn’t get in sooner to have the study, and staff were frustrated as they didn’t have a process to handle the backlog,” explains labor co-lead Patty Carter, a polysomnography technician and member of SEIU Local 105.

After modifications to the equipment, the team has not had to repeat a single study. As a result, appointment wait times are down from 17 days to eight days.

What’s a sleep study?

A sleep study monitors what the body does while asleep. It is typically ordered by a physician to figure out the reason for sleep problems a patient is experiencing, such as sleep apnea.

According to the National Heart, Lung and Blood Institute, “Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.” It’s a cycle that can repeat up to 30 times or more per hour, resulting in poor sleep quality that can impact your day.

“Sleep apnea is one of the leading causes of excessive daytime sleepiness,” according to the institute. Untreated, it can increase the risk of serious problems like high blood pressure, heart attack, stroke and diabetes.

At Skyline Medical Office, the team sees on average 50 patients per week for sleep apnea studies, and at the nearby Rock Creek Medical Office, it sees about 20 patients a week. The studies involve using a device the patient attaches to the front of his or her chest and also to his or her finger. It locks around the mid-section. The machine tracks and monitors blood oxygen while the patient is sleeping and generally is administered at home.

Requests for sleep studies are increasing, and the team is making plans to handle the additional patients so appointment wait times do not creep up.

Solving the problem

The team started tracking repeat studies to determine why they were occurring. Team members standardized how the machine was attached to the patient to minimize variation and set up a consistent process so everyone was following the same steps. The team checked the device and software and still couldn’t figure out why there were issues.

Team members’ efforts led them to the local manufacturer of the equipment they were using. After several conversations with the company representative, the CEO of the Colorado-based firm invited team members to the company’s offices to review the problem. Together they went through the steps of using the equipment and discovered there was a problem with the lock that snapped the machine around the patient’s stomach.

The company replaced the locks, and the problem with repeat studies has all but disappeared. Persistence and determination for this UBT paid off. Patients only have to do the study one time, and that puts them on the path to a diagnosis and treatment sooner.

“We saw enormous results,” says Chad McGlothlin, the supervisor.