A Quality Improvement Intervention to Improve Inpatient Pediatric Asthma Controller Accuracy

Area of Science:

• Pediatric Pulmonology
• Healthcare Quality Improvement
• Clinical Pharmacy

Background:

• Inaccurate asthma controller medication at discharge can lead to poor patient outcomes.
• Standardized assessment of asthma control is crucial for effective management.

Purpose of the Study:

• To evaluate the impact of a quality improvement (QI) intervention on the accuracy of pediatric asthma controller medications prescribed at hospital discharge.
• To assess the effect of the QI intervention on the inpatient assessment of asthma control.

Main Methods:

• An interprofessional QI team implemented interventions including improved documentation and standardized language.
• Weekly reviews of pediatric patients discharged with status asthmaticus assessed controller therapy accuracy and asthma control questions.
• Data were analyzed using Nelson rules and interrupted time series analysis.

Main Results:

• The proportion of patients discharged on appropriate controller therapy increased from 60% to 80% (P = .02).
• The assessment of asthma control questions improved from 43% to 98% (P < .001).
• Both improvements were statistically significant.

Conclusions:

• A rigorous QI intervention effectively enhanced the accuracy of asthma controller discharge prescriptions.
• The QI initiative also improved the inpatient assessment of asthma control, leading to better pediatric asthma management.