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Asthma management by an inpatient asthma care team
Simone Ebbinghaus1, Abdul H Bahrainwala
1Children's Hospital of Michigan, Detroit, MI, USA.
Insights
A specialized inpatient asthma service significantly reduced hospital stays and saved costs. This program improved asthma care coordination and patient education for children, particularly benefiting minority populations disproportionately affected by asthma.
Area of Science:
- Pediatric Allergy and Immunology
- Healthcare Management
- Public Health
Background:
- Asthma disproportionately affects children and African Americans, leading to higher rates of emergency visits and hospitalizations.
- African Americans experience higher asthma-related mortality rates compared to Caucasians.
- Standardized inpatient asthma management and education are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the impact of a dedicated Inpatient Asthma Service on patient outcomes and hospital costs.
- To assess the effectiveness of standardized asthma management and patient education provided by an asthma nurse specialist (ANS).
- To improve care coordination and reduce disparities in pediatric asthma management.
Main Methods:
- Implementation of a standardized inpatient asthma management protocol led by an allergy/asthma specialist and an ANS.
- Provision of comprehensive asthma education to patients and families before discharge.
- Facilitation of referrals to outpatient allergy/asthma clinics for continued care.
- Addressing psychosocial factors impacting asthma management.
Main Results:
- Achieved a decrease in average length of hospital stay (LOS) by 12 hours per admission.
- Generated average annual cost savings of $300,000 for the hospital.
- Improved patient and family understanding of asthma management and enhanced care coordination.
- Developed specialized pediatric asthma assessment, teaching, and communication skills among ANS.
Conclusions:
- A specialized Inpatient Asthma Service can significantly improve efficiency and reduce healthcare costs.
- Standardized care and dedicated asthma nurse specialists enhance patient education and care coordination.
- Targeted interventions are necessary to address health disparities in pediatric asthma, particularly for minority populations.
Abstract:
Recent surveillance data indicates that asthma continues to be a major health problem affecting children and African Americans disproportionately in terms of prevalence, emergency department visits, and hospitalization rates (Centers for Disease Control [CDC], 2002). Death rates due to asthma also remain higher in African Americans as compared to Caucasians. At Children's Hospital of Michigan, the Inpatient Asthma Service manages the majority of children hospitalized for asthma. An allergy/asthma specialist and a pediatric nurse trained in asthma management (asthma nurse specialist [ANS]) direct this service, which provides standardized inpatient asthma management according to current asthma care guidelines and asthma education to patients and their families before discharge, encourages referrals to the outpatient allergy/asthma clinic for further asthma management and education, and addresses other medical or social needs related to asthma care. The positive outcomes measured were a decreased length of hospital stay (LOS) by 12 hours per hospital admission and average cost savings of $300,000 annually for the hospital. Other positive outcomes included improved patient and family understanding of asthma and improved coordination of care. The asthma nurse specialists have had the benefit of further developing their pediatric asthma assessment, teaching, and communication skills.
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