Emergency treatment of bronchospastic attacks in an emergency medicine department: effects of a quality improvement project.
New insights have recently changed the therapeutical approach to bronchospastic attack (BA). In this paper we present the results of a quality assurance study devised to: (1) verify the extent to which these new insights are put into practice in our Emergency Medicine Department (EMD); (2) evaluate changes in EMD medical staff behaviour faced with BA after discussion and distribution of medical practice guidelines on the treatment of BA (a document produced by a group of experts in pulmonary medicine working in the EMD on the basis of current literature and personal experiences); (3) assess the impact of such guidelines on quality care. A retrospective analysis demonstrated an incorrect treatment of BA in the EMD. After the introduction of the guidelines we observed: (1) an improvement in physician behaviour that completely agreed with guidelines in 56% of instances after discussion and distribution of the document, in 8% before; (2) an improvement in the outcome of patients treated for BA in the EMD (13 versus 36% relapses for patients treated in the EMD and discharged).
Barboni
E
E
Department of Emergency Medicine, General Hospital of Udine, Italy.
Liva
C
C
Rossi
P
P
Sacher
M
M
Perraro
F
F
D001986:Bronchial Spasm / Q000628:therapy*; D002983:Clinical Competence; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D007558:Italy; D008505:Medical Staff, Hospital / Q000592:standards*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies