title: Outcome of pediatric inpatient asthma clinical pathway implementation in a military medical center.
abstract: A performance improvement project was instituted at our facility to standardize pediatric inpatient asthma care by instituting an asthma clinical pathway (ACP). Formal asthma education and standardized postdischarge follow-up plans for all asthma inpatients were initiated. Patients treated by following the ACP were compared against historically similar patients from the previous 4 years. Differences in hospital length-of-stay (LOS) for patients treated on the ACP were compared to historical LOS. Adherence to The Joint Commission's home management plan of care metric, CAC-3, was also compared. There was a 25% lower hospital LOS in the ACP group compared to historical control group, 45.8 hours versus 60.9 hours (p < 0.002). CAC-3 adherence significantly increased from 48% to 89% (p < 0.001) after initiating formal asthma education. The implementation of a pediatric asthma inpatient performance improvement project was associated with a significant decrease in hospital LOS, when compared to historic controls. It also led to a significant improvement in adherence with The Joint Commission's CAC-3 measures.
authors.affiliation: Department of Pediatrics, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Hsu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Lee
authors.forename: James A
authors.initials: JA
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D019091:Critical Pathways; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006772:Hospitals, Military; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000639:trends*; D008297:Male; D016896:Treatment Outcome; D014481:United States