198883 Development of a Statewide Emergency Department-Based Asthma Surveillance Program- A Report on a System of Assessing and Improving Asthma Activities

Tuesday, November 10, 2009: 10:50 AM

Michael F. McDermott, MD , Pulmonary Medicine, John Stroger Jr. Hospital of Cook County, Chicago, IL
Catherine D. Catrambone, PhD , Rush University College of Nursing, Chicago, IL
Nicole T. Thompson, BA , Rush University College of Nursing, Chicago, IL
Sarah Rittner, MA , Feinberg School of Medicine, Northwestern University, Chicago, IL
Christine Kelsey, MS , Kelsey Associates Ltd, Inc, Chicago, IL
Paula Tanabe, PhD, MPH, RN , Feinberg School of Medicine, Northwestern University, Chicago, IL
Richard Lenhardt, MD, MPH , Division of Pulmonary and Critical Care Medicine, Rush University Medical College, Chicago, IL
Michelle Sergel, MD , Emergency Medicine, John Stroger Jr. Hospital of Cook County, Chicago, IL
Kevin Weiss, MD, MPH , Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Evanston, IL
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.

Learning Objectives:
Design an internet asthma surveillance tool for broad use by Emergency Departments, professional and public health bodies. Define critical variables drawn from national asthma guidelines and put into elements of a standard questionnaire and chart review. Assess asthma severity and practice elements in pre-hospitals status and elements of Emergency Department care and discharge.

Keywords: Asthma, Standards

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 20 plus years of practicing and leading asthma programs in ED and adult asthma clinic. Numerous publications in asthma clinical research and care delivery. 10 plus years of experience in design, administration and evaluation of asthma care practices in Chicago and Illinois.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Asthma Epidemiology
See more of: Epidemiology