1. Chapter Quality Network (CQN) Asthma Pilot Project Our Progress to Date Cooper White MD Chapter Physician Leader Vanessa Shorte, MPH Manager, Chapter Improvement Activities American Academy of Pediatrics

2. I have no relevant financial relationships with the manufacturers(s) of any commercial products(s) and/or provider of commercial services discussed in this CME activity. Cooper White Disclosure Vanessa Shorte Disclosure Slide I have no relevant financial relationships with the manufacturers(s) of any commercial products(s) and/or provider of commercial services discussed in this CME activity

3. Ohio CQN Timeline 3/09 Ohio Selected for CQN 10/10 CQN ends 10/09 LS11/10 LS2 Webinar 4/10 LS3 8/10 LS4 H1N1 EpidemicRecruitment Throughout: Monthly conference calls,and regular practice QI and group meetings.

4. Ohio CQN Successes Use of a Validated Instrument Assessment of reasons for lack of control Stepwise management Influenza Vaccination Followup Appointment Average practice rating rising, 3.4 in 3/10

5. Successes

6. Significant and Sustained Improvement Optimal Care Use of Spirometry at diagnosis Spirometry scheduled or accomplished Updated asthma plan Self management support

7. Steady Improvement

8. Challenges ER visits Hospitalizations % Well controlled Use of asthma indicators at diagnosis Registry Use Expanding SMS beyond asthma education

10. Chapter Progress KD1: Sustainable & Accountable Leadership, focused on Health Outcomes KD2: Create Partnerships KD3: Attractive Motivators and Incentives KD4: Measure Performance KD5: Participate in Organized Quality Improvement

11. National goals at the practice level  Changes in asthma care practices and child health outcome  Successful implementation of practice system change  Clinician investment and commitment to quality improvement work  Transparency and sharing of improvement data  Increased clinician demand for CQN programming

12. National goals at the chapter level  Increased capacity for quality improvement work  Governance group engagement  Sustain QI work at the chapter level  Key partnerships focused on improvement work  Funding and will for continued quality efforts  Increased chapter demand for CQN programming

13. Improvement Work Continuous tests of changeSustainability Imbed in everyday work Scale Up & Spread Taking local improvement And actively disseminating it across a chapter and/or practice Our First 6 months

14. CQN Asthma Pilot Sites MAINE OHIO OREGON ALABAMA

15. How are we doing at the National Level? Practice System Changes Percent of eligible providers collecting data at point of care

16. How are we doing at the National Level? Practice System Changes Registry Implementation Status

17. How are we doing at the National Level? Practice System Changes Options for Practices without a Registry

18. How are we doing at the National Level? Practice System Changes Degree of belief that workflows for collecting data for eligible patients/opportunities at point of care are highly reliable

19. How are we doing at the National Level? Measures of Asthma Care Practices and Health Outcome

20. Optimal Care >70% of patients have “optimal” asthma care (all of the following) assessment of asthma control using a validated instrument stepwise approach to identify treatment options and adjust therapy written asthma action plan patients >6 mos. of age with flu shot (or flu shot recommendation)

21. Optimal Asthma Care Ohio = 71%

22. Self-Management Ohio = 83%

23. Use of a Validated Instrument Ohio = 99%

24. Hospitalizations Ohio = 7%

25. Patients Well-Controlled Ohio = 64%