Development of a Statewide Emergency Department-Based Asthma Surveillance Program- A Report on a System of Assessing and Improving Asthma Activities

The Illinois Emergency Department Asthma Surveillance Program (IEDASP) is an innovative and unique statewide internet-based system assessing performance measures of asthma status and activities before presentation to and during Emergency Department (ED) care. Supported by the Illinois Department of Public Health (IDPH), a pilot program was introduced in 2006 by surveying 18 EDs in targeted high asthma risk Illinois communities. Based on the success of this pilot, the program expanded to all Illinois EDs in 2008.

IEDASP includes two evaluation instruments: 1) a patient or caretaker administered questionnaire addressing demographics, symptoms, clinical events, and provider relationship and 2) a chart review of activities carried out during the ED encounter. EDs enter results onto the study website, and receive reports of patient status and critical performance measures and activities. National guidelines determine measures.

Presently 48 Illinois EDs have reported with 595 subjects. Individual ED, regional and statewide reports are distributed via internet. Statewide measures of prior status include: proportion of patients with moderate/severe asthma symptoms, adults (78%); children (55%); proportion of moderate/severe asthma using inhaled steroids adults (49%); children (49%). Prior status reports also include proportions of very poor control; excessive beta-adrenergics; and frequent ED visits. Statewide ED measures include proportion with initial peak flow, adults (41%), children over 5 (25%); inhaled steroids at discharge, adults (43%), children (40 %.) ED reports also include in-ED and discharge systemic steroids, education and referral.

EDs have participated in improvement collaboratives to bring measures closer to guideline recommendations. Participants report satisfaction with the process.