The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Laurie A. Smrz, Chris Gall, Khris E. O'Brien; Respiratory Care Services, Children's Hospital of Wisconsin, Milwaukee, WI

Background: In 2007, The Joint Commission introduced 3 Children's Asthma Care Measures (CAC) • CAC-1 Use of Relievers for Inpatient Asthma • CAC-2 Use of Systemic Corticosteroids for Inpatient Asthma • CAC-3 Home Management Plan of Care (patients age 2-17 with a primary diagnosis of asthma) Data collection regarding these measures for children’s hospitals began with discharges in April 2007. CAC-3 was initiated as a test measure pending endorsement and was implemented as a production measure beginning July 1, 2008.The National Heart Lung and Blood Institute, National Asthma Education and Prevention Program Expert Panel also recommends that clinicians provide a written action plan to all patients with asthma. Methods: Utilizing Six Sigma improvement methodology, Children’s Hospital of Wisconsin (CHW) implemented a process to provide patients, (2-17 years old) admitted with a primary diagnosis of asthma, with an asthma home management plan. The ultimate goal is 95% of these patients will receive an asthma management plan. The following important key steps were utilized: 1. Bring Together the Right Team: • High Level Leader Champion • Physician Champion • Content Champion • Process Owner • Membership that represents all disciplines affected 2. Meetings: • Focused • Timeline driven • Tasks/responsibilities assigned with expectations of completion prior to next meeting 3. Review Best Practices of Other Institutions: • Auto populate form • Create electronic form with forcing functions 4. Provide Education: • Key stakeholders and committees • Focused on Process and Content • Multiple vehicles for education (written, in-service, oral, web-cast) 5. Process: DMAIC Model: • Define the Project • Measure/Analyze Data (Provide constant feedback and continuous monitoring) • Improve (Implement and evaluate) • Control Results: After implementation of the Asthma management plan CHW compliance with CAC-3 improved from 5% in 2007 to 79% in 2011. Conclusion: While our current compliance rate is 79%, we continue to utilize our improvement methodology to steadily increase these rates to reach our target goal of 95%. Our process identified these key markers for success: • Committed team members • Process owner must be able to navigate the hospital system • Provide education messages through multiple vehicles • Evaluation and feedback are key to sustained improvement Sponsored Research - None