A Practical Model to Transform Childhood Asthma Care

Asthma affects more children than any other chronic condition; nearly 1 in 10 children is affected by the malady. And there are significant racial disparities in asthma outcomes. The death rate among black children with asthma is 5 times higher than that of white children.  While research literature has documented many different methods of improving the quality of asthma treatment, there is little information on how to effectively spread these quality improvement practices among different practices and populations.

This project in partnership with the Child Health Institute of the University of Washington and the Asthma Outcomes Learning Network of the New York Department of Health is implementing evidence-based interventions to improve methods of asthma treatment in 16 pediatric practices. The use of a type of breathing test known as spirometry has proven effective in the diagnosis and treatment of asthma. However, very few pediatric and primary care practices to date have adopted spirometry. While written asthma action plans are a well-recognized best practice in asthma care, only 42% of children surveyed in New York State report having such a plan.

This project will use distance learning technologies and a training CD-ROM, "Spirometry Fundamentals," and will offer technical assistance to New York providers to facilitate the spread of innovative and effective methods of treatment. In Phase 1 of this two-phase project, practices participating in the study will receive spirometers, spirometry software, and training to send de-identified spirometry results data electronically to the project team. In Phase 2, practices will participate in webinars on patient self-management and written asthma action plans. Throughout the project, participating practices will have access to technical assistance and distance learning from expert faculty.

Measures of the effectiveness of the educational interventions will include frequency of appropriate documentation of asthma severity, frequency of spirometry use, and the frequency with which written action plans are present in patient records. If the interventions prove effective, they will be widely disseminated in partnership with the National Initiative for Children's Healthcare Quality and other organizations.

For more information on this project, please contact Steve Hines at (312) 422-2607 or shines3@aha.org.