Authors:
James A. Menke
and
Jeffery Hoffman
Affiliation:
The Ohio State University, United States
Keyword(s):
Asthma Care, Compliance, Quality Improvement, Electronic Medical Record, Pediatrics.
Related
Ontology
Subjects/Areas/Topics:
Biomedical Engineering
;
Clinical Problems and Applications
;
Decision Support Systems
;
Evaluation and Use of Healthcare IT
;
Health Information Systems
Abstract:
Asthma is our institution’s third most common admitting diagnosis with 653 admissions in 2011. The Joint Commission monitors core measures of pediatric asthma care during hospitalization: (1) were relievers given (2) were systemic corticosteroids given and (3) was the patient discharged with a complete asthma action plan (AAP). We describe the sue of three standard quality improvement (QIP) cycles to improve compliance using a computerized AAP. Our historical compliance using paper documentation averaged 32%. In Phase 1, we replaced the paper AAP form with an electronic version within our Electronic Medical Record (EMR) and improved our average compliance to 45%. In Phase 2, we identified barriers to additional improvement and modified the electronic form with soft stops and visual reminders. These modifications improved our compliance to 70%. In Phase 3, we identified remaining barriers, modified the form to include automated decision support and defaulting and improved our complian
ce to 90%. Using this phased QIP, we were able to achieve significant improvement in overall compliance with the core measure of providing an accurate and complete asthma action plan at the time of hospital discharge. With additional QIP cycles, we believe achievement of 100% documentation compliance for this core measure is possible.
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