Ensuring Timely Pulmonary Follow-up after an Inpatient Asthma Hospitalization: A Quality Improvement Initiative.

Area of Science:

• Pulmonology
• Quality Improvement Science
• Pediatric Healthcare

Background:

• Effective management of asthma exacerbations requires consistent outpatient follow-up post-hospitalization.
• Significant variability in scheduling post-discharge pulmonology appointments leads to fragmented care.
• A quality improvement initiative was launched to address these inconsistencies in asthma care.

Purpose of the Study:

• To improve the rate of scheduled outpatient pulmonary follow-up appointments within 45 days of discharge for hospitalized asthma exacerbation patients.
• To increase the attendance rate for these scheduled follow-up appointments.
• To achieve at least 90% of patients scheduled and 80% attendance.

Main Methods:

• A multidisciplinary team developed standardized asthma care guidelines.
• Pulmonary consultation was standardized for pediatric intensive care unit admissions.
• Proactive notification systems were implemented for patients previously seen by pulmonology.

Main Results:

• The percentage of patients scheduled for follow-up increased from 58.7% to 97.3%.
• Appointment attendance rates improved from 45.3% to 85.2%.
• Sustained improvements were observed 3 years post-implementation (93% scheduled, 82.7% attended).

Conclusions:

• Scheduling follow-up appointments before discharge and utilizing active reminders enhances outpatient visit attendance.
• This quality improvement initiative demonstrated success in improving asthma care coordination.
• Further research is warranted to link timely follow-up with improved asthma control and reduced readmissions.