Effectiveness: Asthma Care
Why is this measure important?
Asthma has become a relatively common childhood illness, affecting 7-10% of children and adolescents in the U.S. today. Among children 5-17, asthma is the leading cause of school absences, and it accounts for more hospitalizations than any other childhood disease. It also causes parents to lose significant time at work.
How do we track this measure?
We track our asthma care by looking at how well we perform on three measures that have been developed by the Joint Commission, an independent organization that inspects and accredits health care organizations across the country. They are:
- The use of medicines called relievers that provide short-term relief from asthma symptoms in children who have been hospitalized;
- The use of medicines called systemic corticosteroids that reduce airway inflammation and control moderate to severe asthma symptoms; and
- Development of a discharge and home management plan to help children and parents prevent another asthma-related hospitalization.
Ideally, hospitals should do all three of these things consistently to provide the best care to children with asthma.
How do we compare to other hospitals?
From 2007 through the first quarter of 2010, we have used asthma relievers and systemic corticosteroids 100% of the time in a random sample of patients. This was the same as the performance for all children’s hospitals nationally, as reported by the National Association of Children’s Hospitals and Related Organizations (NACHRI).
In the first quarter of 2010, we provided patients and families with a home management care plan 90% of the time, an increase from 85% in 2009. Our performance was better than the national average, as reported by NACHRI, but we were not in the top 10% of hospitals nationwide – which is our goal.
Excluded from our random sample were patients who were not able to take asthma relief medicines or system corticosteroids, children younger than two and older than 18, patients participating in clinical research trials, and patients who were in the hospital for more than 120 days.
What are we doing to improve?
To reach our goal of providing home management care plans to patients and families at least 95% of the time, our inpatient asthma nurse practitioner has been working with all of our inpatient units (not just our specialized asthma unit) to ensure that they develop comprehensive care plans that include all five elements recommended by the Joint Commission. As a result of this work, we expect our performance to improve.
The five elements that the Joint Commission has recommended be included in every home management care plan include:
- An appointment for follow-up care;
- Information on controlling things that can trigger asthma, such as tobacco smoke, pet dander and dust mites;
- What to do when an asthma attack occurs;
- The proper use of medicines to control asthma; and
- The proper use of medicines to relieve asthma symptoms.