0783 Quality Care of Pediatric Patients Utilizing Continuous Positive Airway Pressure for Obstructive Sleep Apnea

Abstract Introduction Obstructive sleep apnea (OSA) is a sleep related breathing disorder affecting 1-5% of children across all age groups. If left untreated, there is a variety of adverse health effects. Adenotonsillectomy (AT) is a common treatment, however some benefit from the use of continuous positive airway pressure (CPAP) treatment. Due to significant improvements of symptoms when CPAP therapy is applied consistently, we aimed to assess our objective measurements of adherence to PAP therapy along with reduction in their signs and symptoms of OSA. Methods Utilizing the AASM Quality Measures, medical records from patients enrolled in the Children’s Wisconsin Positive Airway Program were reviewed from January 2019 until December 2019. Guidelines were created for the objective use of CPAP, frequency of documentation for adherence, and symptom assessment within a year of CPAP initiation. The structure of the work was performed with the four step Plan-Do-Study-Act cycle and occurred from January 2020 to December 2020. Results Initial review included 62 unique patients started on CPAP during 2019. 61 patients (98%) had appropriate documentation of adherence and 53 patients (89%) with follow up, appreciated a reduction of OSA signs and symptoms. Processes included standardization of electronic medical record templates, respiratory therapist assessment prior to and during clinic visits, and scheduling of appointments when CPAP therapy was recommended. Results remained consistent despite changes during the COVID-19 pandemic and shifts to telehealth visits. 44 patients (100%) had appropriate documentation of adherence prior to their first clinic visit with 40 patients (93%) having a reduction in symptoms by the first clinic visit. Conclusion The development of systems to ensure appropriate usage of CPAP allow for reliable assessments of use and improvements. EMR templates can document CPAP adherence, and reassess symptoms, regardless of visit location or staffing model shifts. We had an initial note template and then developed an auto-populated hyperlink that could be used in telephone and clinic encounters for adherence. With standardization and awareness, we ensured patients were receiving optimal care and treatments were adjusted when challenges were apparent. Support (if any) Internal funding provided by the Children’s Wisconsin Department of Pediatrics