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Education, Teaching, and Quality Improvement |

Helping Children BREATHE- Transforming Asthma Care Through Patient Centered Management Protocols

Claudia Halaby, MD; Ulka Kothari, MD; Eileen Magri, PhD; Aneela Bidiwala, MD; Melodi Pirzada, MD
Author and Funding Information

Winthrop University Hospital, Mineola, NY


Chest. 2015;148(4_MeetingAbstracts):468A. doi:10.1378/chest.2274285
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Abstract

SESSION TITLE: Education, Research, and Quality Improvement

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 25, 2015 at 07:30 AM - 08:30 AM

PURPOSE: Despite the availability of effective medications and asthma management guidelines, for many children asthma remains uncontrolled due to fragmented care. We implemented a patient-centered asthma care management protocol with the goal of creating a high performing microsystem that engages patients in self-management, and reliably delivers asthma care. Our aim was to reduce ED and hospitalization due to asthma by 50%, over one year.

METHODS: In partnership with the Asthma Coalition of Long Island (ACLI), we implemented BREATHE (Bringing Resources for Effective Asthma Treatment through Health Education) a disease-specific Quality Improvement collaborative, aimed to improve the health and the quality of health care delivered to children with asthma. We formed a team of physicians, RNs, RTs, discharge planner, ACLI, and home-care visiting nurses. The project engaged families, PCPs, and school nurses. With monthly educational sessions, frequent debriefing, and utilization of clinical informatics tools to create templates based on NHLBI guidelines, we standardized the implementation of the intervention across providers. The project initially targeted patients admitted to the hospital with asthma and was later launched in an outpatient clinic. Data on all measures and bundle reliability were collected and analyzed on a monthly basis.

RESULTS: Outcome measures for BREATHE “graduates” were ED visits and hospital admissions for asthma. We compare data one year before and after the intervention. For patients that had the intervention in the hospital (n=152) there was a 74% decrease in ED visits and an 89% decrease in hospitalizations for asthma. For patients that had the intervention in the outpatient clinic (n=44) there was a 56% decrease in ED visits and a 74% decrease in hospitalizations for asthma.

CONCLUSIONS: Focusing on patient education, family engagement, and having a multidisciplinary approach, has helped us achieve our goals. Partnering with community (ACLI) and direct frontline engagement are pivotal to a transformation project of this scale. We utilized and optimized our current staffing and the local infrastructure in order to create a high “value” performance improvement initiative.

CLINICAL IMPLICATIONS: Implementation of a multidisciplinary educational intervention proved to be effective in reducing asthma burden in both inpatient and outpatient setting. Launched in a pediatric population, the project has the potential to produce similar results for adults with asthma.

DISCLOSURE: The following authors have nothing to disclose: Claudia Halaby, Ulka Kothari, Eileen Magri, Aneela Bidiwala, Melodi Pirzada

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