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Table 2 Description of the steps of the multidisciplinary consultation process

From: Introduction of a collaborative quality improvement program in the French cystic fibrosis network: the PHARE-M initiative

No.

Step

Who

What

Length (min)

Protocol

1

Installation of the patient

RN

- Setup in the dedicated room

- Collection of new elements since the last visit

- Verification of the results of examinations performed in the community or at the hospital

- Needs for administrative documents (transport passes and certificates)

- Reminder of the hygiene rules (wearing a mask)

- Validation of the day’s clinic visit circuit

5–10

Hygiene — CR

2

Consultation w/nurse

RN

- Taking of measurements (weight and height)

- Recording of the assessment in the patient’s electronic record

- Taking stock of the treatments prescribed and taken

- Care (implantable device, blood draw, etc.)

- Events in the life of the patient to be prepared

- Responses to the patient’s/parent’s questions

20–30

Measurement protocol (height and weight) according to the patient’s age

3

Respiratory assessment

PT

- Implementation of the hygiene protocol

- Taking stock of the physiotherapy practiced in the community and review of instrumental aids

- Taking stock of physical and sports activities

- Physiotherapy session with sputum collection for sputum culture

- Assessment of bronchial congestion

- Recording of the assessment in the patient’s electronic record

40

 

4

PFT (pulmonary function test)

 

- Measurement of respiratory function

- Recording in the patient’s electronic record

10

Recommendations of the American Thoracic Society

5

Other scheduled intervention

 

- Psychological assessment (psychologist), social assessment (social worker), or nutritional assessment (dietician)

- Or individual therapeutic education session

- Recording of the assessment in the patient’s electronic record

30–40

 

6

Medical consultation

Physician

- Additional examination

- Clinical examination

- Review of all treatment

- Response to the patient’s/parent’s questions

- Referral to the referent professional

- Planning of the next visit and need for additional examinations to be performed at the hospital or in the community

- Preparation of prescriptions

- Recording in the patient’s electronic record

- Signing of medical certificates

35–45

End of the course of consultation to benefit from assessments performed by the other professionals recorded in the patient’s electronic record

7

Departure of the patient

Admin. Sec.

or

RN

- Scheduling of the next appointment

- Review of organization for departure (transport, nutritional need, and support)

- Verification that the patient has all useful documents

- Instructions for events by the next visit

- Once the patient leaves the room, disinfection before accommodating the next patient.

30

Disinfection protocol