Related Experiment Video
Updated: Mar 8, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Multifaceted quality improvement initiative to decrease pediatric asthma readmissions
Nadia L Krupp1, Cindy Fiscus2, Russell Webb2
1a Department of Pediatrics , Indiana University School of Medicine , Indianapolis , IN , USA.
Insights
A quality improvement project significantly reduced 30-day asthma readmissions in children by 79.3%. This involved enhancing post-discharge care and education to prevent future hospitalizations.
Area of Science:
- Pediatric Pulmonology
- Healthcare Quality Improvement
- Public Health
Background:
- Childhood asthma is a prevalent chronic condition, frequently leading to hospitalizations.
- Preventing asthma-related hospital admissions is a key objective in pediatric care.
- High 30-day asthma readmission rates necessitate targeted quality improvement initiatives.
Purpose of the Study:
- To reduce the 30-day inpatient asthma readmission rate by 50% within two years.
- To implement and evaluate a multifaceted quality improvement project for pediatric asthma care.
Main Methods:
- Utilized readmission pattern analysis, value stream mapping, and literature review to identify intervention targets.
- Implemented stepwise interventions including increased inhaler availability, modified asthma education, and in-home post-discharge follow-up.
- Monitored the primary outcome of the 12-month average 30-day inpatient readmission rate.
Main Results:
- Achieved a 79.3% reduction in 30-day asthma readmissions, decreasing from a peak of 7.98% to 1.65%.
- The reduction was observed between January 2013 and July 2014, exceeding the initial 50% goal.
Conclusions:
- Comprehensive, multidisciplinary quality improvement efforts can significantly decrease pediatric asthma hospital readmissions.
- Effective interventions require a coordinated approach across the entire continuum of care.
Background:
Asthma is the most common chronic disease of childhood and a leading cause of hospitalization in children. A primary goal of asthma control is prevention of hospitalizations. A hospital admission is the single strongest predictor of future hospital admissions for asthma. The 30-day asthma readmission rate at our institution was significantly higher than that of other hospitals in the Children's Hospital Association. As a result, a multifaceted quality improvement project was undertaken with the goal of reducing the 30-day inpatient asthma readmission rate by 50% within two years.
Methods:
Analysis of our institution's readmission patterns, value stream mapping of asthma admission, discharge, and follow-up processes, literature review, and examination of comparable successful programs around the United States were all utilized to identify potential targets for intervention. Interventions were implemented in a stepwise manner, and included increasing inhaler availability after discharge, modifying asthma education strategies, and providing in-home post-discharge follow-up. The primary outcome was a running 12-month average 30-day inpatient readmission rate. Secondary outcomes included process measures for individual interventions.
Results:
From a peak of 7.98% in January 2013, a steady decline to 1.65% was observed by July 2014, which represented a 79.3% reduction in 30-day readmissions.
Conclusion:
A significant decrease in hospital readmissions for pediatric asthma is possible, through comprehensive, multidisciplinary quality improvement that spans the continuum of care.
Related Concept Videos
01:30Asthma-IV: Nursing Management
First, in...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:29Asthma-I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include: