Improving Inpatient Asthma Management: The Implementation and Evaluation of a Pediatric Asthma Clinical Pathway

Pediatric Quality & Safety
Teresa G MagruderTerry C Wall

Abstract

Asthma exacerbations are a leading cause of pediatric hospitalizations. Despite national guidelines, variability exists in the use and dosing of bronchodilators, oxygen management, and respiratory assessments of patients. We aimed to implement an inpatient Asthma Clinical Pathway (Pathway) to standardize care and reduce length of stay (LOS). A respiratory therapy-driven Pathway was designed for inpatient asthma management. The Pathway included standardized respiratory therapy assessments, bronchodilator dosing, and protocols for progression and clinical worsening. We monitored key process measures. Patients admitted to the Pathway during pilot implementation (March to December 2011) were compared retrospectively with a "Usual Care" cohort admitted during the same period. We compared average LOS, average billed charges per hospitalization (charges), and 30-day readmissions between groups. Statistical process control charts were utilized to analyze LOS and charges for all asthma admissions following Pathway implementation (March 2011 to September 2016). Readmissions and Pathway removals were balancing measures. During pilot, Pathway patients (n = 153) compared with "Usual Care" patients (n = 166) had shorter LOS (0.95 versus 1.86...Continue Reading

References

Jul 1, 1997·Archives of Pediatrics & Adolescent Medicine·T S Kwan-GettE K Marcuse
Oct 28, 1998·Archives of Pediatrics & Adolescent Medicine·K M McDowellC M Kercsmar
Jun 1, 2000·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·C S KellyE F Luckstead
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Dec 10, 2016·Hospital Pediatrics·Kathleen W BartlettHeather S McLean

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Citations

Apr 11, 2020·Pediatric Pulmonology·Adolfo L MolinaGabriela R Oates
Jun 26, 2020·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Vineeta MittalSamir S Shah
Jan 7, 2021·Pediatric Quality & Safety·Emily Altick HartfordLori E Rutman
Jun 1, 2021·Current Problems in Pediatric and Adolescent Health Care·Uchenna C Ewulonu, Heather Dyer

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Software Mentioned

Pathway
Clinical
Clinical Microsystem

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