ASTHMA QI: FOLLOW-UP AND TRANSITIONS OF CARE. Washington Heights Family Health Center 181 st Street. AIM STATEMENT. To increase by 25% over baseline the number of follow-up visits within one month of an asthma exacerbation in the ED or clinic in patients 4-18 years of age. SECONDARY GOALS:.
Washington Heights Family Health Center
To educate 100% of providers about asthma follow up guidelines
To notify 100% of providers via SHM when their patient is seen in the ED for an asthma exacerbation
Schedule 75% of patients with an asthma exacerbation for a follow-up appointment with their primary resident/attending team
Busse et. al. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma—Summary Report 2007. J Allergy Clin Immunol 2007; 120;5 S95-S138.
Fanta, Christopher H. An overview of Asthma Management. UpToDate, August 2013.
Lasley, Mary V. Adherence to Follow-up Recommendations in Asthma. Pediatrics 2008; 122;S211; DOI: 10.1542/peds.2008-2139LLL.
“see your regular doctor by tomorrow at the latest”
“go to your regular clinic on Monday”
“follow up with your PMD – call for appointment”
“see your doctor in 2 to 3 days if not improved”
“See Dr. Coelho at 181st street clinic on Tuesday, October 8th for a walk-in visit”
EXAMPLES OF FOLLOW-UP INSTRUCTIONS
n = 17
n = 8
n = 3
n = 137
Expand and recruit full-time or part-time PCMs in other clinics for improved asthma follow-up visits
Have PICs review weekly asthma list discussed in weekly Medical Home meeting
Generate automatic follow-up visits once visit in the ED coded for “asthma” or “asthma exacerbation”
Increase asthma action plan distribution during follow up visit, an opportunity to discuss actions in “yellow” zone
Sam ZhaoTHANKS TO EVERYONE AT THE 181ST CLINIC!
And special thank you to
Lucille Lebovitz, NP and Joselina Goris!