Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.
To assess gaps in emergency department (ED) asthma management at Florida hospitals.



Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement.



Emergency departments at 10 large hospitals in the state of Florida.



Clinical care providers and health administrators from participating hospitals.



Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts.



Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up.



Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.
Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee (Drs Nowakowski and Carretta and Ms Folsom); and Division of Community Health Promotion (Ms Dudley) and Epidemiology and Evaluation (Ms Forrest), Bureau of Chronic Disease Prevention, Florida Department of Health, Tallahassee.
Alexandra C H
AC
Nowakowski
Henry J
HJ
Carretta
Julie K
JK
Dudley
Jamie R
JR
Forrest
Abbey N
AN
Folsom
D001249:Asthma / Q000628:therapy*; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D005431:Florida; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires