224273 Evidence-based standards to reduce asthma ED revisits and admissions in inner-city public hospitals

Tuesday, November 9, 2010

Consuelo U. Dungca, EdD, RN , New York City Health and Hospitals Corporation, New York, NY
Juliet G. Gaengan, RN, MSA , NYC Health and Hospitals Corporation, New York, NY
Asthma is leading cause of missed school among children and most common cause of hospitalization for 14 and younger. Among adults, asthma causes missed work, ED revisits and activity limitation. In past two decades people w/asthma increased and prevention/control had been challenging. However, asthma can be controlled by adequate education, ongoing follow-up, avoiding trigger exposure, compliance to medicines. If controlled, people can lead normal active lives.

For New York City, Asthma is leading cause of hospitalization and ED revisits for children and adults; mostly indigent, minorities, undocumented, vulnerable populations served by Health and Hospitals Corporation's (HHC) 11 hospitals and 6 diagnostic/treatment centers. Asthma is top pediatric and top ten adult admission diagnoses and accounts for 12% to 15% outpatient pediatric visits, 10% children, 25% adults for ED revisits within 7 days.

An HHC asthma expert multi-disciplinary task force was tasked to develop evidence-based Corporate Best Practice Guidelines in Asthma Care (assessment/reassessment, home/environmental control measures, patient/family education, medication/treatment, Corporate asthma drug formula). The guidelines were implemented in all the hospitals and diagnostic/treatment centers through; staff/patient education/training, patients partners in asthma action plan, buddy system, spacers/medication use, clinic follow-up appointment/home care referral before ED discharge, Telehealth Medicine participation. Asthma vans were donated by Board Members to reach patients home and indicators were measured to evaluate outcomes; ED visit/re-visits w/in 7 days, asthma discharges, appropriate medications. To date, pediatric asthma revisit remain 3.40%, same as 2008 but adult decreased to 5.01% from 5.42% in 2008. Through implementation of evidence-based asthma care guidelines, ED revisits/readmissions reduced

Learning Areas:
Administration, management, leadership
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
1. Describe the development of an asthma evidence-based program. 2. Discuss implementation of best practices as they relate to sections of an evidence-based standard of care. 3. Identify best practices to promote each section within the standard of care.

Keywords: Asthma, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Monitors Asthma Quality Improvement-related initiatives and ensures submissiona and reporting of outcome results.
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.

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