title: Sustaining compliance with pediatric asthma inpatient quality measures.
abstract: To reduce readmission risk in children hospitalized with asthma, The Joint Commission (JC) mandated hospitals to initiate preventive measures and provide patients/caregivers with a home management plan of care (HMPC) at discharge. Standard methods for recording HMPC compliance require hospitals to commit considerable resources. We developed an asthma-specific "reminder and decision support" (RADS) system to facilitate patient discharge while supporting many clinical and administrative needs, including: 1) providers' compliance with asthma preventive measures, 2) creation of patient's discharge instructions, 3) recording HMPC components for JC accreditation, and 4) creation of discharge summaries with auto-faxing mechanism to primary care providers for follow-up. RADS resulted in significant increased and sustained HMPC compliance (73% vs. 89%, p<0.01) and reduced labor time (53 vs. 15 hours/week, p=0.02) compared to standard methods. Most quality improvement interventions achieve short-term goals, but long-term improvements require decision support tools that support multiple needs while minimizing resource use.
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT and.
authors.forename: Flory L
authors.initials: FL
authors.lastname: Nkoy
authors.forename: Bernhard A
authors.initials: BA
authors.lastname: Fassl
authors.forename: Doug
authors.initials: D
authors.lastname: Wolfe
authors.forename: Dayvalena
authors.initials: D
authors.lastname: Colling
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Hales
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Maloney
mesh_terms: D001249:Asthma; D002648:Child; D019983:Guideline Adherence; D006801:Humans; D007297:Inpatients; D010349:Patient Compliance; D010351:Patient Discharge