Let’s read an article a month – October 2020

A cropped screenshot of the first page of the article.

Every month I try to read an open-access article. After reading the article, I share the tittle and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

Link to the article: https://erj.ersjournals.com/content/erj/56/2/1900495.full.pdf

Link to the blog post: https://respiratory.blog/lets-read-an-article-a-month-october-2020/

This month I found a great piece to share with you.  This one falls under original research and Tuberculosis. The objective of this paper is to “ to evaluate the EUROHIS-QOL tool for quantifying QOL in TB-affected people (patients and their contacts) versus healthy community controls, and to assess whether QOL at the time of diagnosis predicts treatment outcome, including survival. ” (p 2).  

Quality of life, tuberculosis and treatment outcome; a case-control and nested cohort study

By: Sumona Datta, Robert H. Gilman, Rosario Montoya, Luz Quevedo Cruz, Teresa Valencia, Doug Huff, Matthew J. Saunders, and Carlton A. Evans.

European Respiratory Journal 2020 56: 1900495;
DOI: 10.1183/13993003.00495-2019

Common abbreviations used in this post and article include Tuberculosis (TB), Quality of Life (QOL), and Activities of daily living (ADL).

Top 3 reasons why I enjoyed reading this article

  • It is a reminder of the impact of this disease.  Infects 10 million people annually with 1.5 million of them passing away because of it (p.2).
  • The authors express that the treatment of a condition is not just the identification and its treatment.  There are psychological and socioeconomic elements that also need to be considered. “It highlights the need to improve TB-related QOL, including the profound dissatisfaction with one’s self, relationships, global QOL, potentially worsened by TB-related distress, stigma and isolation” (p.10). 
    This article also supports the WHO recommendation “such as education and counseling to improve adherence and treatment completion” (p.11)
  • The authors were clear about the strengths and weaknesses of their article.
    (-) It was shared that QOL questionnaires are subjective (p12). 
    (+) The authors recognized the diversity in their study: “15 peri-urban shantytowns and 17 urban communities” (p.12).  

Personal thoughts and reflections

In this article, the World Health Organization’s The End TB Strategy was brought up. I located the page on the WHO’s website: https://www.who.int/tb/strategy/en/.
There is a vast amount of information available, including tabs for Strategy Pillars, Strategy Principles, Adapting the Strategy, Measuring Progress, and TB Elimination.  TB is not unique to other countries.  A 2017 Canadian government statistics showed that “4.9 per 100, 000 of the population” has active TB (https://www.canada.ca/en/public-health/services/diseases/tuberculosis/surveillance.html). I encourage you to take a moment and learn more about TB and its impact on people.

What are your thoughts on this article?  Do you have any experience treating patients with TB? 

Happy learning and reading!

Farzad Refahi

October 1st, 2020


Happy at work?

Woman giving the thumbs up.
Image by Robin Higgins from Pixabay 

Wondering what kind of employer you need to work for? Or wondering how to keep your team happy?   

Prior to the pandemic I occasionally attended networking events.  I heard an interesting mindset from a hard-working, loyal and driven presenter. He asks himself these three questions before applying for any job:

  • Would the opportunity lead to new knowledge or skillset?
  • Would the position give you access to quality mentorship and coaching?
  • Does the role and workplace rate highly on: compensation, work culture and work flexibility.   

Have you ever asked yourself what you are looking for in a workplace?  What makes you choose one offer over the other? What’s your career development look like?

Several factors play into this, including but not limited to one’s personality (intro-/extro-vert), stages in life, career goals, financial needs, work-life balance, available opportunities and many more. 

If you are a manager and/or employer, there are things that you can do to keep your employees happy.  These may include but are not limited to: offering compatible compensation, growth and learning opportunities, providing constructive feedback, flexible scheduling if applicable, and encouraging a respectful work environment among many others. 

Yesterday I attended an anniversary celebration at work to support those who are receiving recognition for their service.  At such challenging times, a small token of appreciation through recognizing people for their loyalty goes a long way.

What are some ways working for your employer keeps you happy, motivated and feeling valued?

Farzad Refahi
September 23, 2020

Patient Experience in Patient Care

A lady on headset pointing to a clipboard and stethoscope.

In my opinion, patient care and patient experience are closely intertwined, especially in highly structured, organized and timed clinical settings such as Pulmonary Function Testing (PFT) labs.  I must emphasize that even at PFT labs, patient-focused care is still at the core. 

There are a few simple ways that I try to improve the patient experience at the lab.  

  • I keep my work station neat and clean.  
  • I anticipate the patient’s needs beforehand.  For example, I have the mouthpiece, nose clips, pen, spacer, requisition, PPE ready before calling the patient in. 
  • If the patient has previously been in the lab, I review the previous comments to be better informed.  For example, if the patient is on home O2, I have the wall O2 extension tubing and nasal prongs ready.  Another example is having the forehead probe ready if the previous 6MWT indicated that forehead probe was used during the walk.
  • I try to be on time, if not a little bit earlier.  This gives me the buffer time just in case the patient requires a little bit more time.  If I start the test early and the testing goes smoothly, at least I get a few minutes for a break until the next person arrives.
  • Working in the Greater Toronto Area exposes me to different languages and different cultures.  To better pronounce people’s last names I Google pronunciations.  I know how silly that may sound.  Search “pronounce [insert last name]” and in most cases, you find some useful resources.  I am not particular with the pronunciation of my first or last name, but this may not be the same with others so I put in a minute to optimize customer service for patient care.

What are some of the ways that you optimize customer service in your patient care?

Farzad Refahi

Sept. 18 2020


CRE Renewal

Photo of the CRE certificate

Today I received the renewal confirmation for my Certified Respiratory Educator (CRE). A quick shoutout to the Canadian Network for Respiratory Care (CNRC). Also, a big thank you to Cheryl Connors for helping me with this renewal and answering all my questions! As I reflected in a recent post, proper diagnosis of patients requires skilled clinicians and supportive organizations. Meeting the requirements for CRE is one way to raise the standards. Learn more at http://www.cnrchome.net/certified-respiratory-educator-(cre).html

Farzad Refahi

Weekly DLCO and Monthly Biological

Mouth piece on and mask off to do a weekly DLCO and monthly biological testing.  Quality control.

Performing my weekly DLCO biological testing and monthly full PFT biological testing.

If you are curious about Hospital and Independent PFT simulations and #calibration, here is a CPSO document: www.cpso.on.ca/admin/CPSO/media/Documents/physician/your-practice/quality-in-practice/cpgs-other-guidelines/ihf-standards-pulmonary-function-studies.pdf

While on this topic, a quick shoutout to Bernie Ho and Tony Kajnar!

Farzad Refahi