Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115312

Van H. Dunn, MD MPH¹, Consuelo Dungca, RN, EdD², and Juliet Gaengan, RN, MSA². (1) Division of Medical and Professional Affairs, New York City Health and Hospitals Corporation, 125 Worth Street, Room 507, New York, NY 10013, (212) 788-3648, van.dunn@nychhc.org, (2) Office of Clinical Affairs, New York City Health and Hospitals Corporation, 125 Worth Street , Suite 427, New York, NY 10013

Asthma is the leading cause of hospitalization for New York City's children and communities (mostly indigent, uninsured, undocumented and minorities) served by the NYC Health and Hospitals Corporation's (HHC) facilities. Presently, asthma is the top pediatric and one of the top ten adult admission diagnoses. In CY 2002, approximately 10% of children and 25% of adults being treated for asthma in the ER returned within 7 days. There were 34,000 pediatrics ER visits and 51,000 adult ER visits and over 6,000 pediatric discharges.

NYC Health and Hospitals Corporation (HHC) is a public benefit Corporation governing eleven acute care facilities; four long term care; six diagnostic & treatment centers; over 100 community health clinics; a managed care organization; a certified home health care agency; and over 37,000 employees. HHC served over 1.3 million individuals annually; 468,387 uninsured patients; and a patient population of 42% Hispanics, 37% African American; 6% Asian, 8% other minority and 7% Caucasian.

The goals are to reduce ER visits, revisits and admissions; provide patient empowerment; and provider training in asthma management in a multifaceted approach. The standard include: adoption of NHLBI Asthma Guidelines; train primary care provider on the standard; incorporate Asthma Action Plan in Medical record; made available to pediatric patients peak flow meters, aero chambers and nebulizers and provide asthma medications. To ensure compliance to the standards, measure of effectiveness were identified, monitored and evaluated. These measures include the goals; home and environmental control; medication treatment guidelines; patient and family education.

Since the implementation of the standard to date the pediatric ER revisits decreased to 3% from 5% with 2,250 admissions from 3,802and adult from 8% to 6% with 3,337 from 5,484.

OBJECTIVES: 1. Describe the development of an asthma evidence based standard. 2. Discuss performance improvement measures to monitor compliance and evaluation. 3. Identify best practices to implement evidence based standards.

Learning Objectives:

• Describe the development of an asthma evidence based standard.
• Discuss performance improvement in monitoring compliance and evaluation.
• Identify best practices to implement evidence based standards.

Keywords: Asthma, Evidence Based Practice

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.