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Improving Asthma Care . Holger Link, M.D. Carrie Phillipi, M.D., Ph.D. Art Jaffe, M.D. Outline. Why You do Care Building teams and partnerships to improve patient outcomes The Doernbecher Experience. Why You Do Care. 75,000. Jonathan David Henry.

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slide1

Improving Asthma Care

Holger Link, M.D.

Carrie Phillipi, M.D., Ph.D.

Art Jaffe, M.D.

outline
Outline
  • Why You do Care
  • Building teams and partnerships to improve patient outcomes
  • The Doernbecher Experience
slide14

Act

Plan

Study

Do

What are we trying to accomplish?

How will we know that a change is an improvement?

What change can we make that will result in improvement?

Asthma

Education

Packets

Asthma

Nurse

Educators

Discharge

Education

Checklist

what is chapter quality improvement
What is Chapter Quality Improvement?

The involvement of AAP chapters in state and/or local activities aimed at improving the quality of care for children.

These activities involve measurement and the collection of data over time to assess changes in practice performance.

slide16

Key Players

  • American Academy of Pediatrics
    • - Project Lead
  • Cincinnati Children’s Hospital Medical Center
    • - QI expertise and coaching
  • 4 Chapters
    • - Alabama
    • - Maine
    • - Oregon
    • - Ohio
  • 49 practices
  • 282 Clinicians
slide17

The Oregon Chapter Team

  • Sandra Miller
  • Theresa Rice
  • Holger Link & Carrie Phillipi
  • Arthur Jaffe (OPS)
slide18

The Oregon Practices

Peace Health Medical Group Riverbend

Peace Health Medical Group Barger

Peace Health Medical Group South

Peace Health Medical Group Downtown

Hillsboro Pediatrics

Southern Oregon Pediatrics

Oregon Medical Group Garden Way

Childhood Health Associates of Salem

Legacy Emanual Childrens Clinic

Doernbecher Pediatrics

Doernbecher Pediatrics Westside

cqn asthma pilot project
CQN Asthma Pilot Project

MAINE

OREGON

OHIO

ALABAMA

12 Practices

11 Practices

13 Practices

13 Practices

49 Practices

282 Clinicians

how are we doing at the national level practice system changes
How are we doing at the National Level?Practice System Changes

Registry Implementation Status

how are we doing at the national level practice system changes1
How are we doing at the National Level?Practice System Changes

Options for Practices without a Registry

commitment to quality as a result of cqn participation
Commitment to Quality as a result of CQN Participation

No Change in my commitment to QI work, 9%

More committed to QI work, 91%

slide25

Improvement Work

Continuous tests

of change

Sustainability

Imbed in everyday work

Our First 6 months

Improvement Work

Scale Up & Spread

Taking local improvement

And actively disseminating it

across a chapter

and/or practice

goals
GOALS
  • Describe structure and process
  • Discuss our local focus
  • Show baseline data
  • Choosing PDSA’s and tracking results
  • Successes and challenges
  • The future: sustainability and generalizability
base line well controlled visits vs patients1
Base-line: % Well-controlled (visits vs patients?)

OOPS!

No data reported back from AAP!!

well controlled through july 2010
% Well-controlled Through July, 2010

DCH General Pediatrics Clinic

Oregon

base line optimal care
Base-line: % Optimal Care

DCH General Pediatrics Clinic

Oregon

drilling down on optimal care
Drilling Down On Optimal Care

Validated Instrument

Step-wise Approach to Care

drilling down on optimal care1
Drilling Down On Optimal Care

Flu shot given or recommended

Use of Asthma Action Plan

targets of opportunity
Targets of Opportunity
  • Validated Instrument

- ACT and TRACK forms

  • Asthma Action Plan

- PDSA iterations of plans

- EPIC issues

- The saga continues

optimal care good news in june
Optimal Care: Good News in June!!!

DCH General Pediatrics Clinic

Oregon

and then there was july
And then there was July

DCH General Pediatrics Clinic

Oregon

the future
The Future
  • Sustainability

- What happens when the project ends?

  • Generalizability

- Asthma management throughout Oregon

- Chronic care management in DCH

  • Registry

- Management of populations, not patients

- Clinical care vs. research data base

- Options for all of us