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The Joint Commission Children's Asthma Care quality measures and asthma readmissions

Bernhard A Fassl1, Flory L Nkoy, Bryan L Stone

  • 1Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.

Pediatrics
|August 22, 2012
PubMed

Insights

Implementing an asthma care process model improved compliance with Children's Asthma Care measure 3 (CAC-3), significantly reducing hospital readmissions. CAC-1 and CAC-2 showed little value as quality measures in this pediatric asthma study.

Area of Science:

  • Pediatric Healthcare Quality Improvement
  • Asthma Management in Children
  • Healthcare Process Optimization

Background:

  • The Joint Commission introduced Children's Asthma Care (CAC 1-3) measures to enhance pediatric inpatient asthma care quality.
  • The validity of these CAC measures has not been previously established.
  • A quality improvement study was conducted to assess the impact of an asthma care process model (CPM) on provider compliance and hospitalization outcomes.

Purpose of the Study:

  • To evaluate changes in provider adherence to CAC 1-3 measures following the full implementation of an asthma care process model.
  • To examine the association between CPM implementation and pediatric asthma hospitalization outcomes.

Main Methods:

  • A retrospective study included 1865 children (2-17 years) hospitalized for acute asthma from 2005-2010.
  • Data were analyzed across preimplementation, implementation, and postimplementation periods.
  • Logistic regression controlled for covariates including age, gender, race, insurance, and time.

Main Results:

  • Provider compliance significantly increased for CAC-3 (0% to 87%, P < .01) post-CPM implementation.
  • Increased CAC-3 compliance correlated with a sustained reduction in asthma readmissions (17% to 12%, P = .01).
  • No significant changes were observed in other hospitalization outcomes like length of stay or PICU transfers.

Conclusions:

  • The asthma care process model effectively improved compliance with CAC-3, validating its utility as a quality measure.
  • The study demonstrated a significant, albeit delayed, decrease in asthma readmission rates post-CPM implementation.
  • CAC-1 and CAC-2 measures demonstrated high baseline compliance, questioning their value in quality improvement initiatives.
Abstract

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