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The care team at WMed Health’s Cystic Fibrosis practice has spent the last two years focusing on improvements to provide a better experience for the patients they serve.

Those quality improvements were highlighted in a November site visit with officials from the state of Michigan who oversee Children’s Special Health Care Services throughout the state.

WMed Health’s Cystic Fibrosis practice provides comprehensive care for patients with cystic fibrosis from infancy to adulthood with respiratory tract problems. The care team also works with other patients who need treatment of acute and chronic lung diseases, asthma care, care for children with disabilities who have respiratory problems, care for patients with home mechanical ventilator needs and care for adults and pediatric patients with cystic fibrosis.

The robust care team includes Mariam Ischander, MBChB, a pediatric pulmonologist and an assistant professor in the medical school’s Department of Pediatric and Adolescent Medicine; a pharmacist, a dietician, a medical social worker, a respiratory therapist, a pharmacy technician, a medical assistant, a clinical psychologist, two registered nurses and a nurse care coordinator. Patients from all over Southwest Michigan come to Kalamazoo to see the care team every three months. The team also sees patients who have positive screens for cystic fibrosis as newborns.

The practice, started by Dr. Douglas Homnick in the 1990s, sees about 40 patients a year. It is an affiliate program of the Cystic Fibrosis Center at Helen DeVos Children’s Hospital in Grand Rapids.

November’s site visit highlighted quality improvement projects the care team championed over a 16-month period upon securing a grant from the Cystic Fibrosis Foundation. The practice improved its downtime, which is the amount of time that patients spend in the clinic without seeing a provider, improved the transition of patients from the pediatric model of care to the adult model of care, and provided every patient with a stethoscope, clipboard and pen to decrease cross contamination, Dr. Ischander said. 

The practice also improved its mental health screening for patients and their caregivers, provided physical therapy to hospitalized cystic fibrosis patients, made the results of genetic testing available in electronic medical records and had team members complete training, Dr. Ischander said.

“We worked for the last year on improving the training of our team,” Dr Ischander said. “We have a highly experienced team that is available to provide expertise in cystic fibrosis to our local patients and families.”

Team members took precautions to keep patients healthy as the COVID-19 pandemic raged, providing each patient with a scale, a home spirometer machine and a pulse oximeter. Patients were able to connect with their providers via video instead of coming to appointments in person, Dr. Ischander said. 

WMed Health’s other Children’s Multidisciplinary Specialty (C���ϲʿ���ֱ��S) clinical practices, including diabetes, severe asthma, pediatric cleft lip and palate care and pediatric multiple disability care will undergo similar site visits from the state of Michigan throughout the next three years, said Patricia Curtis, WMed Health Quality Improvement and Allied Health Manager. 

State officials look at the composition of the care team, how they perform comprehensive care assessments, how providers partner with patients and their families to design an integrated plan of care, set goals, and make referrals to other specialties, and how they improve their practice, Curtis said. 

“The state officials were particularly impressed with our multidisciplinary plan of care that is developed in partnership with our patients and their families and is given to them in the after-visit summary,” Curtis said. “The patient is able to leave the clinic with all recommendations from every member of the multidisciplinary team so they can act on those recommendations before their next visit.”

“We’re always working to keep up with advancements in medical care as we train our future physicians,” Curtis said. “The cystic fibrosis team watches over what’s changing and advancements in medicine. They’re making a difference in terms of quality of life for their patients.”

Having a program to focus on her son’s lifelong diagnosis just minutes from their house saves a day of travel and treatment for the whole family, said Portage resident Rachel Millward, whose youngest child, Mason, has cystic fibrosis.

“I know so many other families who have to make a whole day trip or have to get a hotel room or spend the night somewhere because there are no clinics near them,” Millward said. “I feel we’re very lucky to have it so close.”

Millward said she does not hesitate to contact members of the care team, who she has gotten to know well since Mason started seeing them seven years ago as an infant.

Having a child with cystic fibrosis can be challenging, but the clinic provides great support in a timely manner with whatever her family needs, Millward said.

‘It can be hard, having a child with a disease that isn’t curable,” Millward said. “The clinic itself has always shown its support getting us whatever is needed. Even when we’re hospitalized, Dr. Ischander’s relationship with Mason is amazing. He loves her and he loves everybody at the clinic.”