Improving Asthma in Pediatric Practice

Abstract

Pediatric asthma is a significant public health problem. It is the third cause of pediatric hospitalizations, costing $20 billion in 2016. In the US, approximately 6 million children have asthma. Despite available guidelines, implementation is lagging with only 35 % of providers using guidelines. The question was does provider compliance of the NAEPP 2007 asthma guidelines improve through an electronic health record (EHR) template in a pediatric primary care practice?" A quality improvement project implemented an EHR template for pediatric asthma visits and provider education to support the compliance of following the NAEEP 2007 asthma guidelines. A retrospective EHR chart review of charts within the same seasonal time frame, ages 5-12yrs was done to determine documentation pre-and post-project implementation. The chi- square was used for statistical significance. Data reviewed were documentation of action plan, severity, adherence to follow-up appointment, prescribing of prevention medication, ED visits and hospitalizations, C-ACT score, spirometry use, education, and missed school days. Documentation of asthma action plan increased from 10 % to 74 % p = 0.001., spirometry rose from 4% to 32 % p =.011, asthma education increased from 60 % to 98% p=.000, follow up adherence rose from 60% to 98% p = .000 and asthma severity categorized improved from 32% to 100 % p=. 011. Statistical significance was shown in 7 out of the 8 quality measurements. The area of prescribing controller medication for persistent asthma showed clinical significance with 58% to 100% improvement, but was not statistically significant (p=.258) because clinical knowledge was present with the providers prior to the intervention on managing persistent asthma. Results support the hypothesis that an EHR template with evidence-based guidelines improved provider documentation of an asthma action plan, severity, follow-up, and prescribing control medication, ED visits, hospitalizations, missed school days, C-ACT score, spirometry and asthma education. View a PDF of this Poster Presentation