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CHW Home Visit Protocol for Asthma Management

The CHW Working Group ensures integrity in hiring, training, and intervention for community health workers in asthma management. They develop protocols, train and supervise CHWs, and monitor progress. The protocol includes behavior change plans, inhaler education, home environmental assessments, and tailored patient education handouts for triggers. Collaboratively created plans are reviewed and updated at each visit. The curriculum acts as a training guide and reference source for CHWs. Recommendations for improving the CHW MOP layout and frequency of home environmental checklists are discussed. Provision of spacers and other logistics are considered.

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CHW Home Visit Protocol for Asthma Management

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  1. Overview of Community Health Worker Home Visit MOP CHW Working Group Asthma Guidelines Working Group 7.16.2014

  2. CHW Working Group • The CHW Working Group will guide the activities of the CHW Coordinating Center at Sinai, ensuring the integrity of the CHW training, hiring and intervention process.

  3. CHW Working Group Members

  4. CHW Working Group • Responsibilities • Assist with Year 1 focus groups • Finalize the home visit intervention protocol, building off of existing protocols (Sinai’s, Molly’s, etc.) • Participate in the identification, selection and development of appropriate education and support materials to be provided to clients • Development of ED discharge packet • Participate in the recruitment of CHWs • Train CHWs • Supervise CHWs • Develop Quality Assurance activities and protocols • Monitor intervention progress • Consult with Asthma Guidelines Working Group

  5. List of Documents for Discussion • Components of overall CHW Home Visit MOP • CHW Home Visit Protocol • Teach to Goal MOP (Medication Use) • Home Environmental MOP • Home Trigger Assessment • Home Environmental Checklist • Patient Educational Handouts - Triggers • CHW Curriculum

  6. CHW Home Visit Protocol • Guides CHWs as they complete the asthma education portion of each home visit, ensuring a certain level of consistency • Follows the proposed home visit schedule: • Visit 1: 2-3 days post ED discharge • Visit 2: 2 weeks post ED discharge • Visit 3: 1 month post ED discharge • Visit 4: 3 months post ED discharge • Visit 5: 6 months post ED discharge

  7. CHW Home Visit Protocol

  8. CHW Home Visit Protocol • At all visits: • Behavior Change Plan, outline specific short-term goals for family to work towards by next visit, will be collaboratively created. • Reviewed and updated at each visit • Referrals will be made as necessary (e.g., complex housing issues, social services, etc.) • Medication technique will be assessed and re-taught as needed • Home Visit Inhaler Assessment and Education Protocol: Teach To Goal (TTG) • Checklists

  9. Teach to Goal MOP • Overview of TTG • Tailored, pt-centered • Device technique checklists • Objective measures • MDI/Diskus/Twisthaler/ Turbohaler/ Nebulizer • TTG @ each visit • Patient/Parent • Additional info • Cleaning technique • Medication dose tracking sheet

  10. Home Environmental MOP • Created in partnership with Asthma Guidelines WG • Outlines specific procedures to be taken by CHWs to address triggers identified during the Home Environmental Assessment (HEA) • HEA – thorough walk-through of the home environment conducted by CHW – emphasis on child’s bedroom, kitchen, living room and overall cleaning techniques and frequency

  11. Home Environmental MOP • HEA to be conducted at 2-week, 3-month & 6-month visits • MOP focuses on primary triggers: cockroaches, rodents, tobacco smoke • Secondary triggers: mold and dust mites • Begins with shortened overview of protocol and education points for each trigger, then refers to pages with further detail on procedures to address each trigger • All other triggers included in appendix

  12. Home Environmental MOP • Patient Educational Handouts – Triggers • One for each of the primary and secondary triggers • Provide overview of: • Why each is a trigger • What to look for/pictures of trigger • Advocates for allergy testing • Action steps to avoid trigger • Will also have other patient handouts regarding other triggers (CHW WG to finalize)

  13. CHW Curriculum • CHW “bible” of information – does not include procedures • Used as a guide for the CHW training process – all topics in the curriculum are covered in training • Supplements the CHW MOP – acts as a reference for more detailed information on all educational topics covered in home visits

  14. CHW Curriculum • Divided into 8 sections, Asthma and CHW Core Skills: • CHW Background • Asthma Basics • Asthma Education and Devices • Motivational Interviewing • Patient Self-Management and Goal Setting • Patient Documentation: How to write case notes • Collaborating with Medical Professionals

  15. For discussion • Layout of the CHW MOP • Suggestions for making it more user-friendly? • Frequency of Home Environmental Checklist • Currently at 2-week, 3-month and 6-month visits – ok? • Provision of spacers • Will we be providing spacers at home visits or will this happen at ED discharge? • Others? • Comments/suggestions?

  16. Questions/Comments?

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