Improving asthma severity and control screening in a primary care pediatric practice

Area of Science:

• Pediatric Pulmonology
• Primary Care Medicine
• Quality Improvement in Healthcare

Background:

• Asthma is a prevalent chronic childhood illness requiring ongoing management.
• Patients with uncontrolled asthma often miss routine check-ups, hindering effective care.
• Periodic assessment of asthma severity and control is crucial for optimal management.

Purpose of the Study:

• To enhance asthma control and severity screening in a primary care setting.
• To implement a validated tool for all asthma patients aged 4-21 years during any clinical visit.
• To improve the systematic assessment of asthma control and severity.

Main Methods:

• A quality improvement team developed a protocol to administer the Asthma Control Test (ACT).
• The ACT, a validated questionnaire, was administered to all patients with a prior asthma diagnosis or asthma medication during any visit.
• Staff scored the ACT, integrated it into encounter sheets for physician review, and documented findings.

Main Results:

• The percentage of patients with assessed asthma control increased from 10% to 85% after three Plan-Do-Study-Act (PDSA) cycles.
• The implementation of the ACT did not disrupt patient flow in a busy primary care practice.
• The protocol successfully integrated asthma control assessment into routine clinical encounters.

Conclusions:

• Routine screening using a validated tool like the ACT can significantly improve asthma control assessment in primary care.
• Timely identification and management of asthma severity and control can potentially reduce emergency department or urgent care visits.
• Integrating validated asthma assessment tools into all patient visits is an effective quality improvement strategy.