Lora Bergert1, Shilpa J Patel2, Chieko Kimata3, Guangxiang Zhang4, Wallace J Matthews2. 1. Departments of Pediatrics, andKapi'olani Medical Center for Women and Children, Honolulu, Hawaii; and lbergert@kapiolani.org. 2. Departments of Pediatrics, andKapi'olani Medical Center for Women and Children, Honolulu, Hawaii; and. 3. Hawaii Pacific Health, Honolulu, Hawaii. 4. Biostatistics and Data Management Core, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii;
Abstract
OBJECTIVE: We sought to achieve 100% compliance with all 3 Children's Asthma Care (CAC; CAC-1, CAC-2, CAC-3) measures and track attendance at follow-up appointments with the patient-centered medical home. The impact of these measures on readmission and emergency department utilization rates was evaluated. METHODS: This quality improvement study evaluated compliance with CAC measures in pediatric patients aged 2 to 18 years old hospitalized with a primary diagnosis of asthma from January 1, 2008, through June 30, 2012. A multidisciplinary Asthma Task Force was assembled to develop interventions. Attendance at the follow-up appointment was tracked monthly from January 1, 2009. Readmission and emergency department utilization rates were compared between the preimplementation period (January 1, 2006, through December 31, 2007) and the postimplementation period (January 1, 2008, through June 30, 2012). RESULTS: The preimplementation period included 231 subjects and the postimplementation period included 532 subjects. Compliance with CAC-3 was 95% from October 1, 2009, through June 30, 2012. Compliance with the postdischarge follow-up appointment was 69% from January 1, 2009 through September 30, 2009, increasing significantly to 90% from October 1, 2009, through June 30, 2012 (P < .001). Postimplementation readmission rates significantly decreased in the 91- to 180-day postdischarge interval (odds ratio: 0.29; 95% confidence interval: 0.11-0.78). CONCLUSIONS: In children hospitalized with asthma, compliance with the asthma core measures and the postdischarge follow-up appointment with the primary care provider was associated with reduced readmission rates at 91 to 180 days after discharge. We attribute our results to a comprehensive set of interventions designed by our multidisciplinary Asthma Task Force.
OBJECTIVE: We sought to achieve 100% compliance with all 3 Children's Asthma Care (CAC; CAC-1, CAC-2, CAC-3) measures and track attendance at follow-up appointments with the patient-centered medical home. The impact of these measures on readmission and emergency department utilization rates was evaluated. METHODS: This quality improvement study evaluated compliance with CAC measures in pediatric patients aged 2 to 18 years old hospitalized with a primary diagnosis of asthma from January 1, 2008, through June 30, 2012. A multidisciplinary Asthma Task Force was assembled to develop interventions. Attendance at the follow-up appointment was tracked monthly from January 1, 2009. Readmission and emergency department utilization rates were compared between the preimplementation period (January 1, 2006, through December 31, 2007) and the postimplementation period (January 1, 2008, through June 30, 2012). RESULTS: The preimplementation period included 231 subjects and the postimplementation period included 532 subjects. Compliance with CAC-3 was 95% from October 1, 2009, through June 30, 2012. Compliance with the postdischarge follow-up appointment was 69% from January 1, 2009 through September 30, 2009, increasing significantly to 90% from October 1, 2009, through June 30, 2012 (P < .001). Postimplementation readmission rates significantly decreased in the 91- to 180-day postdischarge interval (odds ratio: 0.29; 95% confidence interval: 0.11-0.78). CONCLUSIONS: In children hospitalized with asthma, compliance with the asthma core measures and the postdischarge follow-up appointment with the primary care provider was associated with reduced readmission rates at 91 to 180 days after discharge. We attribute our results to a comprehensive set of interventions designed by our multidisciplinary Asthma Task Force.
Authors: Kohei Hasegawa; Yusuke Tsugawa; Sunday Clark; Carly D Eastin; Susan Gabriel; Vivian Herrera; Jane C Bittner; Carlos A Camargo Journal: Chest Date: 2016-04-04 Impact factor: 9.410
Authors: Katherine A Auger; Tamara D Simon; David Cooperberg; James Gay; Dennis Z Kuo; Michele Saysana; Christopher J Stille; Erin Stucky Fisher; Sowdhamini Wallace; Jay Berry; Daniel Coghlin; Vishu Jhaveri; Steven Kairys; Tina Logsdon; Ulfat Shaikh; Rajendu Srivastava; Amy J Starmer; Victoria Wilkins; Mark W Shen Journal: Pediatrics Date: 2014-12-08 Impact factor: 7.124
Authors: Alexander F Glick; Jonathan S Farkas; Joseph Nicholson; Benard P Dreyer; Melissa Fears; Christopher Bandera; Tanya Stolper; Nicole Gerber; H Shonna Yin Journal: Pediatrics Date: 2017-08 Impact factor: 7.124
Authors: Melanie A Ruffner; Sarah E Henrickson; Marianne Chilutti; Robert Grundmeier; Jonathan M Spergel; Terri F Brown-Whitehorn Journal: Ann Allergy Asthma Immunol Date: 2018-08-28 Impact factor: 6.347
Authors: Michelle Y Hamline; Rebecca L Speier; Paul Dai Vu; Daniel Tancredi; Alia R Broman; Lisa N Rasmussen; Brian P Tullius; Ulfat Shaikh; Su-Ting T Li Journal: Pediatrics Date: 2018-10-23 Impact factor: 7.124
Authors: Kavita Parikh; Matt Hall; Chén C Kenyon; Ronald J Teufel; Grant M Mussman; Amanda Montalbano; Jessica Gold; James W Antoon; Anupama Subramony; Vineeta Mittal; Rustin B Morse; Karen M Wilson; Samir S Shah Journal: J Pediatr Date: 2018-02-01 Impact factor: 4.406