Asthma Standardization

BACKGROUND Asthma is a common pediatric chronic condition that affects approximately 7 million children We currently have over 5,000 children with asthma in our primary care clinics Only approximately 50% of our patients with asthma indicate that their asthma is well-controlled Only slightly over 50% of our patients with persistent asthma who take controller medications, have the appropriate prescriptions for medications  

Asthma Standardization Key Driver Diagram (KDD) Drivers (Family Voice) Project leaders: Lisa Crosby DNP, APRN-CNP, Jennifer de Klerk, MSN, RN BSN Revision Date: 10/2517 Drivers (Family Voice) Global Aim Key Drivers Interventions (LOR #) Effective, continuous and appropriate use of prescribed medications by patient Weekly reporting of refills on controllers written in the past week (% of 3 or less) Decrease in asthma ED utilization and admissions. I should have a controller medicine on hand because I know it is important. Family Automate the process where appropriate Patients family understands difference between rescue and controller medications and why medicine was prescribed I know which medication is which SMART Aim Standardized refill process to review level of asthma control, last controller refill Increase the percentage of children requiring controller meds that have appropriate prescriptions for these meds from 54% to 80% by Q4. Community Proactive identification of patients in need of medicine I can help reach those who are yet to be reached Pharmacy Utilization : Asthma Outreach Reliable contact and communication with patient and family Alternative methods of follow-up (phone, telehealth, groups, in-community) Population Health System Gen Peds Medicaid population with asthma : When I come, the Clinic/Care works well. Clear and standardized roles and responsibilities – everyone knows what they are supposed to do Mutual asthma plan development Legend Potential intervention Active intervention Adopted/Abandoned intervention Note: LOR # = Level of Reliability Number, e.g., LOR 1

CHANGE WE ARE TRYING (PDSA) Date Week of May 7, 2018 PDSA Cycle CYCLE 1 Driver from KDD: Pharmacy Utilization   PLAN Objective Controller medication in the home for the patient Prediction & Measure  Enrolling in pharmacy delivery will ensure that patient has controller medication at home Steps of Plan (To-do List) Offer pharmacy delivery to a patient with persistent asthma on a controller DO (Did the test go according to the plan?) In progress STUDY (What did you learn?) ACT (Adapt, Adopt, Abandon)

MEASURES AND RESULTS

Asthma Care Coordinator CONTACT US TEAM MEMBERS Last Name First Name Role Crosby* Lisa Clinical Manager De Klerk Jennifer FPC Clinical Manager Morehous John Medical Director Chigaga Esi Provider Lead Heist Abby FPC team Adler Devin PPC team Thulin Ann PPC Team Kleiman Julie PPC Clinical Manager Burkhardt Mary Carol Samaan Zeina Szumlas Greg Physician Lead Berenguer Monserate HPC Team Mahaffey Jaime Asthma Care Coordinator High Kristy