The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

DANE COUNTY ASTHMA COALITION EMERGENCY DEPARTMENT PROJECT

J. M. Misustin1, K. K. Shanovich2, R. Yngsdal-Krenz1, N. Jain3, S. Zirbel-Donisch4


Background: The Dane County Asthma Coalition (DCAC) Emergency Department project was designed to standardize the care of asthmatic patients within the Dane County Emergency Departments (EDs). The objectives are to build an evidence-based best practice asthma treatment guideline; discharge patients with an Inhaled Corticosteroid (ICS); and initiate a follow up visit with a Primary Care Provider (PCP). The desired outcomes are prescribing an ICS and to reduce the number of acute care visits through the Emergency Departments. This abstract summarizes the experiences at the University of Wisconsin Hospital and Clinics.

Methods: Utilizing the National Heart Lung and Blood Institute (NHLBI) guidelines, an acute care treatment asthma algorithm was designed. Prior to implementation of the asthma project, education was provided to the Respiratory Care Practitioners (RCP's), ED physicians, and staff. An Asthma Ed Coordinator was appointed and the role defined. All patients with an admitting diagnosis of asthma were seen by the RCP to implement the algorithm. Patients discharged from the ED were given a prescription and voucher for an ICS. In addition, the patient was given discharge information on asthma education, along with a blank asthma action plan to be completed by the PCP during subsequent clinic appointment. The patients ED visit information was faxed to the PCP who would than schedule a follow-up appointment. The Asthma Ed Coordinator’s role is to assure that the information faxed to the physician was received and a follow-up appointment was scheduled.

Results:
January 02 –April 31, 2007
Age <18 years Age >19 years
Total seen 31 48
Currently on ICS 14 (45%) 16 (33.3%)
New prescription for ICS 7 (22.5%) 18 (37.5%)

Experience: The project limitations included difficulty obtaining follow-up care for the uninsured patients and coordination problems regarding consistent application of the protocol.

Conclusion: The DCAC Emergency Department Project has been implemented for 4 months at the UW Hospital and
Clinics. Preliminary data has shown an increase in prescribing of ICS by 22.5% in children and 37.5% in
adults. Future goals: standardizing asthma care in all Dane County Hospital ED’s; coordinating PCP follow-up care;
reducing asthma related healthcare utilization; and improving the prescribing of ICS.

January - April 31,2007
 AgeAge>/=19 years
Total
seen
31 48
Currently on ICS 14 (45%) 16(33.3%)
New Prescription for ICS 7(22.5%) 18 (37.5)
   



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