Multifaceted quality improvement initiative to decrease pediatric asthma readmissions

Nadia L. Krupp, Cindy Fiscus, Russell Webb, Emily C. Webber, Teresa Stanley, Rebecca Pettit, Ashley Davis, Judy Hollingsworth, Deborah Bagley, Marjorie McCaskey, John Stevens, Andrea Weist, A. Ioana Cristea, Heather Warhurst, Benjamin Bauer, Michele Saysana, Gregory Montgomery, Michelle Howenstine, Stephanie Davis

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Asthma is the most common chronic disease of childhood and a leading cause of hospitalization in children. A primary goal of asthma control is prevention of hospitalizations. A hospital admission is the single strongest predictor of future hospital admissions for asthma. The 30-day asthma readmission rate at our institution was significantly higher than that of other hospitals in the Children's Hospital Association. As a result, a multifaceted quality improvement project was undertaken with the goal of reducing the 30-day inpatient asthma readmission rate by 50% within two years. Methods: Analysis of our institution's readmission patterns, value stream mapping of asthma admission, discharge, and follow-up processes, literature review, and examination of comparable successful programs around the United States were all utilized to identify potential targets for intervention. Interventions were implemented in a stepwise manner, and included increasing inhaler availability after discharge, modifying asthma education strategies, and providing in-home post-discharge follow-up. The primary outcome was a running 12-month average 30-day inpatient readmission rate. Secondary outcomes included process measures for individual interventions. Results: From a peak of 7.98% in January 2013, a steady decline to 1.65% was observed by July 2014, which represented a 79.3% reduction in 30-day readmissions. Conclusion: A significant decrease in hospital readmissions for pediatric asthma is possible, through comprehensive, multidisciplinary quality improvement that spans the continuum of care.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalJournal of Asthma
DOIs
StateAccepted/In press - Feb 24 2017

Fingerprint

Quality Improvement
Asthma
Pediatrics
Inpatients
Hospitalization
Patient Readmission
Process Assessment (Health Care)
Continuity of Patient Care
Nebulizers and Vaporizers
Chronic Disease
Education

Keywords

  • barriers to care
  • control/management
  • hospitalization
  • multidisciplinary
  • Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Multifaceted quality improvement initiative to decrease pediatric asthma readmissions . / Krupp, Nadia L.; Fiscus, Cindy; Webb, Russell; Webber, Emily C.; Stanley, Teresa; Pettit, Rebecca; Davis, Ashley; Hollingsworth, Judy; Bagley, Deborah; McCaskey, Marjorie; Stevens, John; Weist, Andrea; Cristea, A. Ioana; Warhurst, Heather; Bauer, Benjamin; Saysana, Michele; Montgomery, Gregory; Howenstine, Michelle; Davis, Stephanie.

In: Journal of Asthma, 24.02.2017, p. 1-8.

Research output: Contribution to journalArticle

Krupp, NL, Fiscus, C, Webb, R, Webber, EC, Stanley, T, Pettit, R, Davis, A, Hollingsworth, J, Bagley, D, McCaskey, M, Stevens, J, Weist, A, Cristea, AI, Warhurst, H, Bauer, B, Saysana, M, Montgomery, G, Howenstine, M & Davis, S 2017, 'Multifaceted quality improvement initiative to decrease pediatric asthma readmissions ', Journal of Asthma, pp. 1-8. https://doi.org/10.1080/02770903.2017.1281294
Krupp, Nadia L. ; Fiscus, Cindy ; Webb, Russell ; Webber, Emily C. ; Stanley, Teresa ; Pettit, Rebecca ; Davis, Ashley ; Hollingsworth, Judy ; Bagley, Deborah ; McCaskey, Marjorie ; Stevens, John ; Weist, Andrea ; Cristea, A. Ioana ; Warhurst, Heather ; Bauer, Benjamin ; Saysana, Michele ; Montgomery, Gregory ; Howenstine, Michelle ; Davis, Stephanie. / Multifaceted quality improvement initiative to decrease pediatric asthma readmissions . In: Journal of Asthma. 2017 ; pp. 1-8.
@article{2ea1e817c4b64fbba45d378a252f4c7c,
title = "Multifaceted quality improvement initiative to decrease pediatric asthma readmissions",
abstract = "Background: Asthma is the most common chronic disease of childhood and a leading cause of hospitalization in children. A primary goal of asthma control is prevention of hospitalizations. A hospital admission is the single strongest predictor of future hospital admissions for asthma. The 30-day asthma readmission rate at our institution was significantly higher than that of other hospitals in the Children's Hospital Association. As a result, a multifaceted quality improvement project was undertaken with the goal of reducing the 30-day inpatient asthma readmission rate by 50{\%} within two years. Methods: Analysis of our institution's readmission patterns, value stream mapping of asthma admission, discharge, and follow-up processes, literature review, and examination of comparable successful programs around the United States were all utilized to identify potential targets for intervention. Interventions were implemented in a stepwise manner, and included increasing inhaler availability after discharge, modifying asthma education strategies, and providing in-home post-discharge follow-up. The primary outcome was a running 12-month average 30-day inpatient readmission rate. Secondary outcomes included process measures for individual interventions. Results: From a peak of 7.98{\%} in January 2013, a steady decline to 1.65{\%} was observed by July 2014, which represented a 79.3{\%} reduction in 30-day readmissions. Conclusion: A significant decrease in hospital readmissions for pediatric asthma is possible, through comprehensive, multidisciplinary quality improvement that spans the continuum of care.",
keywords = "barriers to care, control/management, hospitalization, multidisciplinary, Pediatrics",
author = "Krupp, {Nadia L.} and Cindy Fiscus and Russell Webb and Webber, {Emily C.} and Teresa Stanley and Rebecca Pettit and Ashley Davis and Judy Hollingsworth and Deborah Bagley and Marjorie McCaskey and John Stevens and Andrea Weist and Cristea, {A. Ioana} and Heather Warhurst and Benjamin Bauer and Michele Saysana and Gregory Montgomery and Michelle Howenstine and Stephanie Davis",
year = "2017",
month = "2",
day = "24",
doi = "10.1080/02770903.2017.1281294",
language = "English (US)",
pages = "1--8",
journal = "Journal of Asthma",
issn = "0277-0903",
publisher = "Informa Healthcare",

}

TY - JOUR

T1 - Multifaceted quality improvement initiative to decrease pediatric asthma readmissions

AU - Krupp, Nadia L.

AU - Fiscus, Cindy

AU - Webb, Russell

AU - Webber, Emily C.

AU - Stanley, Teresa

AU - Pettit, Rebecca

AU - Davis, Ashley

AU - Hollingsworth, Judy

AU - Bagley, Deborah

AU - McCaskey, Marjorie

AU - Stevens, John

AU - Weist, Andrea

AU - Cristea, A. Ioana

AU - Warhurst, Heather

AU - Bauer, Benjamin

AU - Saysana, Michele

AU - Montgomery, Gregory

AU - Howenstine, Michelle

AU - Davis, Stephanie

PY - 2017/2/24

Y1 - 2017/2/24

N2 - Background: Asthma is the most common chronic disease of childhood and a leading cause of hospitalization in children. A primary goal of asthma control is prevention of hospitalizations. A hospital admission is the single strongest predictor of future hospital admissions for asthma. The 30-day asthma readmission rate at our institution was significantly higher than that of other hospitals in the Children's Hospital Association. As a result, a multifaceted quality improvement project was undertaken with the goal of reducing the 30-day inpatient asthma readmission rate by 50% within two years. Methods: Analysis of our institution's readmission patterns, value stream mapping of asthma admission, discharge, and follow-up processes, literature review, and examination of comparable successful programs around the United States were all utilized to identify potential targets for intervention. Interventions were implemented in a stepwise manner, and included increasing inhaler availability after discharge, modifying asthma education strategies, and providing in-home post-discharge follow-up. The primary outcome was a running 12-month average 30-day inpatient readmission rate. Secondary outcomes included process measures for individual interventions. Results: From a peak of 7.98% in January 2013, a steady decline to 1.65% was observed by July 2014, which represented a 79.3% reduction in 30-day readmissions. Conclusion: A significant decrease in hospital readmissions for pediatric asthma is possible, through comprehensive, multidisciplinary quality improvement that spans the continuum of care.

AB - Background: Asthma is the most common chronic disease of childhood and a leading cause of hospitalization in children. A primary goal of asthma control is prevention of hospitalizations. A hospital admission is the single strongest predictor of future hospital admissions for asthma. The 30-day asthma readmission rate at our institution was significantly higher than that of other hospitals in the Children's Hospital Association. As a result, a multifaceted quality improvement project was undertaken with the goal of reducing the 30-day inpatient asthma readmission rate by 50% within two years. Methods: Analysis of our institution's readmission patterns, value stream mapping of asthma admission, discharge, and follow-up processes, literature review, and examination of comparable successful programs around the United States were all utilized to identify potential targets for intervention. Interventions were implemented in a stepwise manner, and included increasing inhaler availability after discharge, modifying asthma education strategies, and providing in-home post-discharge follow-up. The primary outcome was a running 12-month average 30-day inpatient readmission rate. Secondary outcomes included process measures for individual interventions. Results: From a peak of 7.98% in January 2013, a steady decline to 1.65% was observed by July 2014, which represented a 79.3% reduction in 30-day readmissions. Conclusion: A significant decrease in hospital readmissions for pediatric asthma is possible, through comprehensive, multidisciplinary quality improvement that spans the continuum of care.

KW - barriers to care

KW - control/management

KW - hospitalization

KW - multidisciplinary

KW - Pediatrics

UR - http://www.scopus.com/inward/record.url?scp=85014542097&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014542097&partnerID=8YFLogxK

U2 - 10.1080/02770903.2017.1281294

DO - 10.1080/02770903.2017.1281294

M3 - Article

C2 - 28118056

AN - SCOPUS:85014542097

SP - 1

EP - 8

JO - Journal of Asthma

JF - Journal of Asthma

SN - 0277-0903

ER -