Related Experiment Video
Updated: Jan 18, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Asthma care bundle and pathway to improve asthma management in a community paediatric inpatient unit, a quality
Marie-Noelle Trottier-Boucher1,2, Sarah Heighington2, Melissa Holland2
1Department of Pediatrics & Island Medical Program, Faculty of Medicine, University of British Columbia, Victoria, British Columbia, Canada.
Insights
Implementing an asthma care bundle significantly reduced hospital stays for pediatric patients without intensive care. This improvement, driven by a standardized care pathway, offers a 35% decrease in length of stay.
Area of Science:
- Pediatric Pulmonology
- Healthcare Improvement Science
- Quality Improvement in Healthcare
Background:
- Asthma is a leading chronic condition in children, frequently resulting in emergency visits and hospitalizations.
- Reducing pediatric asthma exacerbation hospitalizations is a critical healthcare objective.
Purpose of the Study:
- To decrease inpatient length of stay (LOS) for pediatric asthma exacerbations.
- To evaluate the impact of a systemic asthma management intervention on hospital LOS.
Main Methods:
- Utilized the Institute for Healthcare Improvement Model for Improvement.
- Implemented an inpatient asthma care bundle including a discharge checklist, standardized care pathway with nurse-led bronchodilator titration, and team education.
- Monitored LOS for patients with and without Pediatric Intensive Care Unit (PICU) stays.
Main Results:
- Mean LOS for patients without PICU stay decreased by 35% (from 52 to 34 hours), a sustained improvement.
- Mean PICU LOS remained unchanged.
- Caregiver confidence in asthma management increased significantly post-discharge (from 6/10 to 9/10).
Conclusions:
- An inpatient asthma care bundle effectively reduced LOS for pediatric patients without PICU admission.
- The standardized inpatient asthma management pathway was the most effective component of the intervention.
- The intervention improved caregiver confidence without increasing adverse outcomes like readmissions or need for advanced respiratory support.
Background:
Asthma is the most common chronic paediatric condition and a frequent cause of emergency department visits and hospitalizations.
Objectives:
The project objective was to decrease inpatient length of stay (LOS) for asthma exacerbations between May 2021 and 2022.
Methods:
The Institute for Healthcare Improvement Model for improvement was employed to study if systemic changes to asthma management could reduce hospital LOS. The inpatient asthma care bundle consisted of a discharge checklist, standardized care pathway that allowed nurse titration of bronchodilator based on an objective scoring tool and standardized team education.
Results:
The pre-intervention mean inpatient LOS was 56 h, 100 h for patients with a Paediatric Intensive Care Unit (PICU) stay, and 52 h for patients without a PICU stay. While the mean PICU LOS remained unchanged, the mean LOS for patients without PICU stay decreased to 34 h and was sustained through the project's completion. The percentage of healthcare professionals feeling "comfortable"/'very comfortable' caring for asthmatic patients remained unchanged during the project (100%). Caregivers' confidence regarding asthma management mean score increased from 6/10 to 9/10 after hospital discharge. No statistical increase respiratory-based emergency department presentation within 10 days of discharge, use of high-flow ventilation and transfer to PICU was noted.
Conclusions:
Implementing an inpatient asthma care bundle reduced the mean LOS for patients without PICU stay from 52 to 34 h, which represents a 35% decrease. The most impactful intervention was the implementation of the inpatient asthma management pathway.
Related Concept Videos
01:30Asthma-IV: Nursing Management
First, in...
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.
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
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: