The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

IMPROVING DELIVERY OF EVIDENCE-BASED ASTHMA CARE: ASTHMA EDUCATION AND SPIROMETRY TRAINING FOR MEDICAL ASSISTANTS AT FEDERALLY QUALIFIED HEALTH CENTERS.

Len Picha1, Adam Baus2, Cynthia Keely-Wilson3, Charles Menders1; 1Respiratory Care, Charleston Area Medical Center, Charleston, WV; 2Community Medicine, West Virginia University, Office of Health Services Research, Morgantown, WV; 3West Virginia Asthma Education and Prevention Program, Charleston, WV

Background: West Virginia (WV) ranks high in the prevalence of asthma in both adults (12%) and children (13%) [Behavioral Risk Factor Surveillance System 2009]. Federally Qualified Health Centers (FQHCs) serve the state' s underserved and low socio-economic populations, both demographic risk factors for asthma. FQHCs serve 1 in 6 West Virginians. From 2006 to 2008, 2457 patients with asthma were identified across 8 WV FQHCs, but only 1747 (72%) had one or more office visits and just 58 (3%) had documented spirometry results. To empower patients to self-manage asthma symptoms effectively [WVAC 2010], patients should have 2 well visits/year and spirometry every 1-2 years [NHLBI 2007]. Methods: An asthma education program including spirometry training was developed to use at WV FQHCs thru hospital partnerships. Tools, best practices, and evidence-based guidelines were compiled from valid, reliable sources [Delivering High Quality Asthma Care: National Asthma Forum 2008; WVAC 2007; NHLBI EPR-3 2007; NHLBI Pace 2006]. The Cabin Creek Health System (CCHS) FQHC was identified due to strong leadership and successful diabetes self-management programs. Medical Assistants (MA) were trained in spirometry, evidence-based asthma care and patient education [ALA Asthma 101]. Patient education also included a personal asthma action plan. Nursing staff completed spirometry competency interventions prior to MA administering patient studies. An asthma patient registry was created within the electronic medical record (EMR) at CCHS, where benchmarks of Good Asthma Control were built as alerts in the EMR. Results: Asthma education for MA significantly improved asthma related knowledge (67% pre and 94% post, p < 0.0001), and spirometry training markedly improved spirometry related knowledge (54% pre and 90% post, p < 0.0001). During spring 2011, MA completed 165 spirometry tests. Thirty-four (34) patients had asthma visits. Each patient received a spirometry test, asthma education, and personalized asthma action plan. Conclusion: Providing education and spirometry training to MA at CCHS improved adherence to evidence-based guidelines, by teaching staff how to empower patients with self-management techniques. Future work includes training additional medical providers and expanding the registry.
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