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Kirsten Bennett MS RD LD November 8, 2013 Asthma Educator Institute Albuquerque, New Mexico

The NAECB definition of Asthma Educator includes: “…. The educator monitors asthma education program outcomes and recommends modifications to improve quality and effectiveness.” (NAECB Candidate Handbook, 2002, p. 1) 11/8/2013 3

G. Langley et al The Improvement Guide. Jossey-Bass Publishers, San Francisco, 1996; xxi

 How can we apply QI methodology and strategies to individual care of patients with asthma?  How can we apply QI methodology and strategies to healthcare systems to improve asthma care and outcomes? 11/8/2013 5

Program implementation ends here Impact Process Formative Outcome Program implementation occurs here

EvaluationDevelopmentEvaluationImplementation

 Define the best care that can be provided in this setting  Identify the gap between current practice and best practice  Participate in closing that gap

F-O-C-U-S  Find a time to talk  Organize your team  Clarify processes  Understand variations  Select a process to improve

 Identify the gap between current practice and best practice (or current care for the individual) What is the baseline? What are the potential causes of our baseline observations? What are potential alternatives to current practice?

 Simple operational change  Short cycle evaluation of change  Sustainable after change is made

 Formative  P (plan)  What do we need to do and for whom and by when?  Process  D (do)  How will we attempt this process and who specifically will be responsible for the various parts?  Outcome  S (study)  How will we measure what we are doing and what will we compare it to?  Impact  A (act)  Did this attempt at change or implementation meet our objective?

 PDSA personality exercise 11/8/

Outcomes = Benefits to or changes Inputs Resources dedicated or consumed by the program; Constraints Activities What the program does with its inputs to fulfill its mission Outputs The direct products of program activities Outcomes Initial All providers using EBP with all asthma patients Intermediate Better asthma control and QOL Long-term Fewer ED visits; lower cost for management

 PDSA handouts  Flip Charts with Markers  Scenario 1: How will we know if the current asthma management plan documented for a patient (or population of patients) results in acceptable control (routinely and objectively?  Scenario 2: Reduce ED visits in a particular patient.  Scenario 3: Ensure every child with asthma has at least one planned visit for asthma management every 6 months. 11/8/

11/8/ Thank you