The value of care algorithms.
The use of protocols or care algorithms in medical facilities has increased in the managed care environment. The definition and application of care algorithms, with a particular focus on the treatment of acute bronchospasm, are explored in this review. The benefits and goals of using protocols, especially in the treatment of asthma, to standardize patient care based on clinical guidelines and evidence-based medicine are explained. Ideally, evidence-based protocols should translate research findings into best medical practices that would serve to better educate patients and their medical providers who are administering these protocols. Protocols should include evaluation components that can monitor, through some mechanism of quality assurance, the success and failure of the instrument so that modifications can be made as necessary. The development and design of an asthma care algorithm can be accomplished by using a four-phase approach: phase 1, identifying demographics, outcomes, and measurement tools; phase 2, reviewing, negotiating, and standardizing best practice; phase 3, testing and implementing the instrument and collecting data; and phase 4, analyzing the data and identifying areas of improvement and future research. The experiences of one medical institution that implemented an asthma care algorithm in the treatment of pediatric asthma are described. Their care algorithms served as tools for decision makers to provide optimal asthma treatment in children. In addition, the studies that used the asthma care algorithm to determine the efficacy and safety of ipratropium bromide and levalbuterol in children with asthma are described.
Myers
Timothy
T
Department of Pediatric Pulmonology, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio 44106, USA. Timothy.Myers@uhhs.com
D000465:Algorithms; D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D001986:Bronchial Spasm; D019317:Evidence-Based Medicine; D006801:Humans; D005791:Patient Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D011785:Quality Assurance, Health Care