Items That Are Essential to Have for an ILD Clinic Items That Are Important to Have for an ILD Clinic
Members of the ILD team
 Physicians
 Having expertise in ILD (a certain number of years working in ILD patient care)
 Having at least 2 or more pulmonologists working the ILD clinic
 Nurses Dedicated ILD nurse
 If a clinic has advanced practice providers
 Close supervision by physicians
 Their role should be mainly longitudinal care of ILD patients
 Research coordinators Clinic coordinators
Fellows and trainees
Infrastructure of ILD clinics
 General
 ILD clinic sees a minimum number of patients per year
 ILD clinic sees a minimum of 100 unique patients/ya
 Minimum number of clinics per week
 Ease of access to clinic
 Triaging and rerouting referrals to ILD clinics from general pulmonary clinics
 Triaging of ILD patients before new patient visit to avoid multiple visits (prescheduling tests before the visit, obtaining prior records and imaging, and so forth)
 The maximum time from referral to new appointment is less than 2 mo for a standard new patient visitb Maximum time from referral to new appointment is less than 7-10 d for an urgent patient visit
 Patient management strategies
 Providing a mix of primary management, collaborative/shared care, and consultative management Providing primary management of ILD care
 Exposure history
 Obtain a structured occupational and environmental exposure history for all new ILD patients
Resources for ILD clinics
 Pulmonary rehabilitation
 A pulmonary rehabilitation facility in close proximity (within a 30-60-min drive from the center) to the ILD clinica
 Ancillary services within the same institution
 General rheumatology Access to rheumatologists with expertise in ILD
 Thoracic radiology Access to sleep clinic
 Pulmonary pathologya
 Thoracic surgeon
 Pulmonary hypertensiona
 Cardiology
 Palliative care
 Experience in treating patients with advanced lung diseases
 Availability in outpatient, inpatient, and hospice care
 Pulmonary function testing
 Same-day appointments as the ILD clinic visit
 Radiology
 Dedicated ILD HRCT protocol
 HRCT available same day or next day of clinic visita
 Research
 Participation in research
 Participation in clinical trials
 Participation in patient registriesa
 Patient education
 Patient education is delivered by physiciansa
 Patient education is delivered by nurses
 ILD clinic participates in local patient support groups
Multidisciplinary conference
 Having a multidisciplinary conference Frequency is at least once/2 wks
 Staff (routinely participates in ILD conference)
 Pulmonologists Trainees
 Radiologists
 Pathologists
 Discussing the following types of patients at multidisciplinary conference
 Complex cases with diagnostic or therapeutic dilemmas
 Patients who already have undergone surgical lung biopsy
 Patients in whom a surgical lung biopsy is being considered