Strategies for the Management of a Pulmonary Function Laboratory

Pulmonary function tests (PFTs) are imperative to the diagnosis and management of people with respiratory symptoms and lung disease. PFTs require expertise to obtain both high-quality tests and proficiency in test interpretation. In this review, we provide recommendations for obtaining high quality test results in an efficient and cost-effective manner guided by available evidence and expert opinion. The Medical Director plays a critical role in pulmonary lab operations and is ultimately responsible for lab performance. Responsibilities of the medical director will be reviewed and discussed. Quality control is an underappreciated part of the pulmonary lab that is imperative to obtaining high-quality tests. What constitutes a “complete PFT” and the order that tests are performed may differ among labs. We suggest an approach to the performance of spirometry, bronchodilator responsiveness testing, diffusing capacity, lung volumes, and tests of respiratory muscle strength that maximizes clinical utility and lab efficiency. Appropriate resources, time, and expertise are needed to run an efficient pulmonary function laboratory capable of performing high quality testing.