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Improving Asthma Outcomes through Systems Change: The Breathe Initiative
Saturday, March 5, 2016: 1:30 PM
Room 503 (Convention Center)
Claudia Guglielmo, MPA, AE-C, , ,
Rationale:

Despite advances in diagnostics and pharmacotherapy to improve asthma care, adherence to evidence- based guidelines (EPR-3, GINA) remains suboptimal. Both patient and provider issues contribute to poor adherence. Community-based asthma coalitions can facilitate a community of practice where multidisciplinary team practice can improve outcomes. 

Methods:

Community needs assessments were performed utilizing SPARCS data from Long Island’s Nassau, Suffolk and Queens Counties.  Our asthma coalitions brought together stakeholders from key institutions offering inpatient care for children with asthma.  Based on zip codes hospitals that served catchment areas with high asthma hospitalization rates for children 0-17 were selected. 

In each institution a common but unique guidelines-based infrastructure was developed, focusing on outcomes improvement through education. Multidisciplinary teams were established and trained utilizing Physician Asthma Care Education (PACE). Checklists were developed to ensure patient and family education and skills training during hospitalizations with follow up through pediatric and subspecialty referrals, home care visits and school re-entry to close the loop.

Results:

To date multidisciplinary teams and over 1500 children with asthma and their families have participated in BREATHE within five urban and suburban hospital centers. Results from a recent sample of 170 patients from a single center showed a significant reduction in asthma readmissions:  283 admissions one year prior to BREATHE enrollment, 40 readmissions one year post; p < .0001, using the Wilcoxon signed rank test.  

Conclusions:

BREATHE (Bringing Resources for Effective Asthma Treatment though Health Education) is a successful quality improvement initiative that has a substantial and sustainable reduction in asthma readmission rates.