Assessing quality of asthma care in your practice-- The Asthma APGAR

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Presentation transcript:

Assessing quality of asthma care in your practice-- The Asthma APGAR Barbara P. Yawn, MD, MSc Director of Research Olmsted Medical Center Rochester, MN USA February 20, 2004 Melbourne, Australia

Assumption: Quality Result

Objectives: Identify quality related outcomes Suggest quality indicators Develop process to assess indicators Use indicators to modify practice

Quality should focus on: Outcomes that matter to patients Outcomes that matter to families Outcomes that matter to clinicians Outcomes that matter to quality monitors In that order

ASTHMA APGAR A=Activities P=Persistence G=triGGers A=Asthma Medications R=Response to Therapy

% of patients with documented activity limits APGAR Results A=Activities 25% % of patients with documented activity limits

% of patients with frequency of daytime symptoms documented APGAR Results P=Persistence Day time symptoms 67% % of patients with frequency of daytime symptoms documented

% of patients with frequency of night time symptoms documented APGAR Results P=Persistence Night time symptoms 15% % of patients with frequency of night time symptoms documented

The severity score addresses the baseline symptom assessment: Does not address the asthma that is being treated nor does it consider attacks

% of patients with documented triggers APGAR Results G=triGGers Are them mentioned or treated 34% % of patients with documented triggers

APGAR Results A=Asthma medications Prescribed medications 75% ? Percent that are really taking them that way % of patients with prescribed medications documented and then actual medications taken documented

% of patients with the response to therapy documented APGAR Results R=Response to therapy Did they get better or worse 50% % of patients with the response to therapy documented

GAPS? Your impressions of the data ? What is currently working well? Why is it working well? What would you like to improve? Systems that you want to change?

Solutions A patient asthma APGAR Ask the nurse to give patient the APGAR to complete Develop patient expectations so that they give you their APGAR Use as a control score