The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

UTILIZING AN IMPROVEMENT METHODOLOGY TO IMPLEMENT THE JOINT COMMISSION CHILDREN'S ASTHMA CARE MEASURE 3.

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