title: The impact of status asthmaticus practice guidelines on patient outcome and physician behavior.
abstract: This study assesses the effects of a status asthmaticus guideline on patient outcome and pediatrician behavior in a staff model health maintenance organization (HMO). The guidelines were drafted by an asthma specialist in the HMO and then discussed with key clinical personnel. A preprinted protocol order form was developed to help implement the guideline into clinical practice. The medical records of pediatric patients admitted to the hospital with status asthmaticus before (N = 67) and after (N = 59) guideline development and implementation were reviewed. This study demonstrates that locally developed, treatment-specific guidelines based on scientific evidence and combined with a staff consensus process and a user-friendly protocol form can influence physician behavior and patient outcome positively.
authors.affiliation: Nursing Services, Kaiser Foundation Hospital, San Diego, CA 92120.
authors.forename: L Z
authors.initials: LZ
authors.lastname: Webb
authors.forename: D H
authors.initials: DH
authors.lastname: Kuykendall
authors.forename: R S
authors.initials: RS
authors.lastname: Zeiger
authors.forename: S L
authors.initials: SL
authors.lastname: Berquist
authors.forename: D
authors.initials: D
authors.lastname: Lischio
authors.forename: T
authors.initials: T
authors.lastname: Wilson
authors.forename: C
authors.initials: C
authors.lastname: Freedman
mesh_terms: D000293:Adolescent; D002140:California; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D002985:Clinical Protocols / Q000592:standards; D005260:Female; D005568:Forms and Records Control; D006279:Health Maintenance Organizations / Q000458:organization & administration / Q000592:standards; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D010372:Pediatrics / Q000592:standards*; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D013224:Status Asthmaticus / Q000175:diagnosis / Q000628:therapy*