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Published on: November 4, 2010

A Randomized Trial to Increase Outpatient Asthma Referrals Upon Pediatric Emergency Department Discharge

Amy M DeLaroche1, Priya Spencer2, Alexander Wind3

  • 1Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Hospital of Michigan, Detroit, MI.

Pediatric Emergency Care
|July 21, 2026
PubMed

Insights

The Pediatric Asthma Control and Communication Instrument for the Emergency Department (PACCI-ED) significantly increased outpatient asthma care referrals for children after emergency department visits. This tool led to a ten-fold rise in referrals, particularly for those with poorly controlled asthma.

Area of Science:

  • Pediatric Emergency Medicine
  • Asthma Management
  • Healthcare Communication Tools

Background:

  • Acute asthma exacerbations in children frequently lead to emergency department (ED) visits.
  • Effective transition of care from the ED to outpatient settings is crucial for managing pediatric asthma.
  • Current referral practices from EDs for pediatric asthma may be suboptimal, necessitating improved communication tools.

Purpose of the Study:

  • To evaluate if the Pediatric Asthma Control and Communication Instrument for the Emergency Department (PACCI-ED) increases outpatient asthma care referrals.
  • To assess the impact of the PACCI-ED on referral rates following pediatric ED visits for acute asthma exacerbations.

Main Methods:

  • A prospective randomized controlled trial was conducted from November 2021 to April 2023.
  • Parents of children aged 5-11 with acute asthma exacerbations completed the PACCI-ED.
  • ED providers in the intervention group used the PACCI-ED and a summary for discharge recommendations, while the control group did not.

Main Results:

  • Referral rates upon ED discharge were significantly higher in the intervention group (63.9%) compared to the control group (6.3%).
  • The PACCI-ED use resulted in a ten-fold increase in asthma care referrals.
  • Referrals were more common for children with uncontrolled asthma, primarily directed to subspecialty clinics or community asthma programs.

Conclusions:

  • The PACCI-ED is an effective tool for increasing asthma care referrals at pediatric ED discharge.
  • Implementation of the PACCI-ED facilitates better continuity of care for pediatric asthma patients.
  • The instrument particularly benefits children with poorly controlled asthma by connecting them to specialized care.
Abstract

Keywords:
emergency departmentpediatric asthmareferralssubspecialty

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