The use of continuous quality improvement methods to implement practice guidelines in asthma.
National asthma management guidelines have improved awareness of the rising morbidity and mortality from asthma but have not been widely implemented at a local level. This paper describes the use of continuous quality improvement techniques to facilitate the implementation of asthma management guidelines within a tertiary hospital setting. A baseline audit demonstrated satisfactory emergency assessment and treatment, but identified poor compliance with the patient education aspects of the asthma management plan. An evaluation of the literature demonstrated that programs combining asthma education and management were effective when directed towards adults with a recent severe asthma exacerbation. An asthma education and management service was developed to address these deficits. A repeat audit was conducted which identified improvements in asthma control and management skills for patients attending the education program, together with reductions in asthma re-admission rates for patients referred to the service. Ongoing quality assessments will target non-attenders to the service and the maintenance of asthma skills. An area Asthma Health Outcomes Council was formed to address the issues of asthma management throughout the area health service.
Gibson
P G
PG
Respiratory Medicine Unit, John Hunter Hospital, Newcastle, NSW, Australia.
Wilson
A J
AJ
D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D001315:Australia; D002648:Child; D005568:Forms and Records Control; D006801:Humans; D008485:Medical Audit; D010349:Patient Compliance; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012648:Self Care; D017749:Total Quality Management / Q000379:methods