Kapi'olani Medical Center for Women and Children Asthma Task Force
Program Location:
Honolulu, HI
Payer Type:
Other
Reported Outcomes
Description:
The Kapi'olani Medical Center for Women and Children Asthma Task Force quality improvement project was created to study the relationship between compliance with all three of the Children's Asthma Care (CAC) core measures and readmission rates. The hospital formed a multidisciplinary asthma task force that included hospital-based and community physicians, nursing leadership, respiratory therapists, the hospital chief operating officer, and a QI officer.
The 3 elements of CAC for children younger than age 18 years are bronchodilator/reliever medication use, systemic corticosteroid use, and completion of a home management plan of care (which includes a postdischarge appointment with a primary care provider and/or physician name and contact number at discharge). These measures enhance continuity of care from the inpatient to the PCMH setting. For more information, click here.
In 2014, Pediatrics, the official Journal of the American Academy of Pediatrics, published a study that evaluated readmission and emergency department utilization rates between the preimplementation period (January 1, 2006, through December 31, 2007) and the postimplementation period (January 1, 2008, through June 30, 2012). The Kapi'olani Medical Center for Women and Children's asthma task force set its goal at 100% compliance with the CAC core measures. Hospital staff gave all children a follow-up appointment prior to discharge, even those who had no identified primary care physician on admission.
The article concluded, "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."
Fewer ED / Hospital Visits:
- In children hospitalized with an acute asthma exacerbation, compliance with asthma core measures and attendance at a discharge follow-up appointment with the PCMH was associated with a 71% reduction in readmission rates at 91 to 180 days post discharge. Overall, readmission rates were numerically lower post-implementation, but only the 91 to 180 days post-discharge results reached statistical significance.
Improved Access:
- Compliance with the post-discharge follow-up appointments with the PCMH increased from 69% to 90% (p < .001)
Increased Preventive Services:
- Compliance with both CAC-1 (bronchodilator/reliever medication use) and CAC-2 (systemic corticosteroid use) remained >99% during the entire study
- Compliance with CAC-3 (completion of a home management plan of care) increased from a mean of 74% in stage 1 (Jan 2008 - Sept 2009) to 95% in stage 2 (Oct 2009 - June 2012) of the study (p<.001).
Other Outcomes:
- There were no differences in ED utilization rates found between periods (stages 1 and 2 of the study), however the authors note that this could be due to a low baseline.
Data Source(s):
