A Quality Improvement Approach to Decreasing Postdischarge Acute Care Reuse Among Children With Asthma

Area of Science:

• Pediatric Pulmonology
• Healthcare Quality Improvement
• Public Health

Background:

• Asthma is a common pediatric respiratory illness requiring effective post-discharge care.
• High rates of acute care reuse after hospitalization indicate gaps in care and patient management.
• Standardizing clinical pathways and patient education is crucial for improving outcomes in pediatric asthma.

Purpose of the Study:

• To decrease 7-day acute care reuse among children with asthma post-discharge.
• To implement standardized clinical care and patient education strategies.
• To evaluate the impact of quality improvement interventions on pediatric asthma readmissions and emergency department revisits.

Main Methods:

• A quality improvement initiative involving diverse stakeholders was implemented across inpatient, ED, and outpatient settings.
• Interventions focused on resident education, medication access, and asthma education for patients.
• Electronic health records were used to track 7-day acute care reuse rates before and after interventions.

Main Results:

• The mean 7-day acute care reuse rate decreased from 3.7% at baseline to 1.0% during the intervention period.
• A significant reduction of 73% in 7-day asthma-related acute care reuse was achieved.
• The median reuse rate shifted from 3.3% to 0%, with an 8-month period of zero reuse.

Conclusions:

• Standardizing provider training, care processes, and patient education effectively reduced acute care reuse in pediatric asthma patients.
• The quality improvement team successfully achieved and sustained significant reductions in 7-day readmissions and ED revisits.
• This approach demonstrates a successful model for improving post-discharge care and reducing healthcare utilization for pediatric asthma.