Presentation Title

A primary care learning collaborative to improve office systems and clinical management of pediatric asthma

Presenter's Name(s)

Michael V. ChmielewskiFollow

Project Collaborators

Stanley Weinberger, MD (lead author); Kelly Cowan, MD; Keith Robinson, MD; Chris Pellegrino; Judy Shaw, PhD; Valerie Harder, PhD

Time

3:30 PM

Location

Williams Family Room

Abstract

Objective

Pediatric asthma is a common, relapsing-remitting, chronic inflammatory airway disease that when uncontrolled often leads to substantial patient and health care system burden. Improving management of asthma in primary care can help patients stay well controlled.

Methods

The Vermont Child Health Improvement Program (VCHIP) developed a maintenance of certification (MOC) quality improvement (QI) learning collaborative to improve primary care office systems for clinical management of pediatric patients with asthma. Seven months of medical record review data were evaluated for improvements on eight clinical asthma management measures. Pre and post office systems inventory (OSI) detailing adherence to improvement strategies were analyzed for improvement. Regressions were run to test for associations between OSI strategies and asthma management measures post learning collaborative.

Results

This study found significant improvement between pre and post OSI for seven of the nine strategies assessed and from baseline to month seven on seven of the eight clinical asthma management measures. Additionally, one point higher average OSI scores on the assessment and monitoring of asthma severity, asthma control, asthma action plans, and asthma education strategies were associated with significantly greater odds of improvement in their respective asthma management measures.

Conclusion

This eight month, practice-based, QI learning collaborative on pediatric asthma showed broad improvement in office systems and clinical management measures of asthma in primary care. Furthermore, strong associations between certain office systems improvements and corresponding asthma management measures suggests that linking office systems strategies to measures may be a helpful tactic within the learning collaborative model.

Primary Faculty Mentor Name

valerie.harder@med.uvm.edu

Status

Medical Students

Student College

Larner College of Medicine

Program/Major

Biochemistry

Primary Research Category

Health Sciences

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A primary care learning collaborative to improve office systems and clinical management of pediatric asthma

Objective

Pediatric asthma is a common, relapsing-remitting, chronic inflammatory airway disease that when uncontrolled often leads to substantial patient and health care system burden. Improving management of asthma in primary care can help patients stay well controlled.

Methods

The Vermont Child Health Improvement Program (VCHIP) developed a maintenance of certification (MOC) quality improvement (QI) learning collaborative to improve primary care office systems for clinical management of pediatric patients with asthma. Seven months of medical record review data were evaluated for improvements on eight clinical asthma management measures. Pre and post office systems inventory (OSI) detailing adherence to improvement strategies were analyzed for improvement. Regressions were run to test for associations between OSI strategies and asthma management measures post learning collaborative.

Results

This study found significant improvement between pre and post OSI for seven of the nine strategies assessed and from baseline to month seven on seven of the eight clinical asthma management measures. Additionally, one point higher average OSI scores on the assessment and monitoring of asthma severity, asthma control, asthma action plans, and asthma education strategies were associated with significantly greater odds of improvement in their respective asthma management measures.

Conclusion

This eight month, practice-based, QI learning collaborative on pediatric asthma showed broad improvement in office systems and clinical management measures of asthma in primary care. Furthermore, strong associations between certain office systems improvements and corresponding asthma management measures suggests that linking office systems strategies to measures may be a helpful tactic within the learning collaborative model.