Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department

Lori Rutman, Russell Migita, Suzanne Spencer, Ron Kaplan, Eileen J. Klein, Jennifer Walthall

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives Asthma is the most common chronic illness in children and accounts for > 600,000 emergency department (ED) visits each year. Reducing ED length of stay (LOS) for moderate to severe asthmatics improves ED throughput and patient care for this high-risk population. The objective of this study was to determine the impact of adding standardized, respiratory score-based admission criteria to an asthma pathway on ED LOS for admitted patients, time to bed request, overall percentage of admitted asthmatics, inpatient LOS, and percentage of pediatric intensive care unit (PICU) admissions. Methods This was a retrospective study of a quality improvement intervention. Statistical process control methodologies were used to analyze measures 15 months before and after implementation of a modified asthma pathway (June 2010 to December 2012; pathway modification September 2011). Results A total of 3,688 patients aged 1 through 18 years who presented to the ED with an asthma exacerbation during the study period were included. Patients were excluded if they were not eligible for the asthma pathway. Patient characteristics were similar before and after the intervention. Mean ED LOS and time to bed request for admitted asthmatics both decreased by 30 minutes. There was no change in percentage of asthma admissions (34%), mean inpatient LOS (1.4 days), or percentage of PICU admissions (2%). Conclusions Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow.

Original languageEnglish (US)
Pages (from-to)289-296
Number of pages8
JournalAcademic Emergency Medicine
Volume23
Issue number3
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Fingerprint

Hospital Emergency Service
Length of Stay
Asthma
Pediatrics
Patient Care
Pediatric Intensive Care Units
Inpatients
Quality Improvement
Chronic Disease
Retrospective Studies
Population

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Rutman, L., Migita, R., Spencer, S., Kaplan, R., Klein, E. J., & Walthall, J. (2016). Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department. Academic Emergency Medicine, 23(3), 289-296. https://doi.org/10.1111/acem.12890

Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department. / Rutman, Lori; Migita, Russell; Spencer, Suzanne; Kaplan, Ron; Klein, Eileen J.; Walthall, Jennifer.

In: Academic Emergency Medicine, Vol. 23, No. 3, 01.03.2016, p. 289-296.

Research output: Contribution to journalArticle

Rutman, L, Migita, R, Spencer, S, Kaplan, R, Klein, EJ & Walthall, J 2016, 'Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department', Academic Emergency Medicine, vol. 23, no. 3, pp. 289-296. https://doi.org/10.1111/acem.12890
Rutman, Lori ; Migita, Russell ; Spencer, Suzanne ; Kaplan, Ron ; Klein, Eileen J. ; Walthall, Jennifer. / Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department. In: Academic Emergency Medicine. 2016 ; Vol. 23, No. 3. pp. 289-296.
@article{936b92bce9c042aa99c9f21e551ed98e,
title = "Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department",
abstract = "Objectives Asthma is the most common chronic illness in children and accounts for > 600,000 emergency department (ED) visits each year. Reducing ED length of stay (LOS) for moderate to severe asthmatics improves ED throughput and patient care for this high-risk population. The objective of this study was to determine the impact of adding standardized, respiratory score-based admission criteria to an asthma pathway on ED LOS for admitted patients, time to bed request, overall percentage of admitted asthmatics, inpatient LOS, and percentage of pediatric intensive care unit (PICU) admissions. Methods This was a retrospective study of a quality improvement intervention. Statistical process control methodologies were used to analyze measures 15 months before and after implementation of a modified asthma pathway (June 2010 to December 2012; pathway modification September 2011). Results A total of 3,688 patients aged 1 through 18 years who presented to the ED with an asthma exacerbation during the study period were included. Patients were excluded if they were not eligible for the asthma pathway. Patient characteristics were similar before and after the intervention. Mean ED LOS and time to bed request for admitted asthmatics both decreased by 30 minutes. There was no change in percentage of asthma admissions (34{\%}), mean inpatient LOS (1.4 days), or percentage of PICU admissions (2{\%}). Conclusions Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow.",
author = "Lori Rutman and Russell Migita and Suzanne Spencer and Ron Kaplan and Klein, {Eileen J.} and Jennifer Walthall",
year = "2016",
month = "3",
day = "1",
doi = "10.1111/acem.12890",
language = "English (US)",
volume = "23",
pages = "289--296",
journal = "Academic Emergency Medicine",
issn = "1069-6563",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department

AU - Rutman, Lori

AU - Migita, Russell

AU - Spencer, Suzanne

AU - Kaplan, Ron

AU - Klein, Eileen J.

AU - Walthall, Jennifer

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Objectives Asthma is the most common chronic illness in children and accounts for > 600,000 emergency department (ED) visits each year. Reducing ED length of stay (LOS) for moderate to severe asthmatics improves ED throughput and patient care for this high-risk population. The objective of this study was to determine the impact of adding standardized, respiratory score-based admission criteria to an asthma pathway on ED LOS for admitted patients, time to bed request, overall percentage of admitted asthmatics, inpatient LOS, and percentage of pediatric intensive care unit (PICU) admissions. Methods This was a retrospective study of a quality improvement intervention. Statistical process control methodologies were used to analyze measures 15 months before and after implementation of a modified asthma pathway (June 2010 to December 2012; pathway modification September 2011). Results A total of 3,688 patients aged 1 through 18 years who presented to the ED with an asthma exacerbation during the study period were included. Patients were excluded if they were not eligible for the asthma pathway. Patient characteristics were similar before and after the intervention. Mean ED LOS and time to bed request for admitted asthmatics both decreased by 30 minutes. There was no change in percentage of asthma admissions (34%), mean inpatient LOS (1.4 days), or percentage of PICU admissions (2%). Conclusions Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow.

AB - Objectives Asthma is the most common chronic illness in children and accounts for > 600,000 emergency department (ED) visits each year. Reducing ED length of stay (LOS) for moderate to severe asthmatics improves ED throughput and patient care for this high-risk population. The objective of this study was to determine the impact of adding standardized, respiratory score-based admission criteria to an asthma pathway on ED LOS for admitted patients, time to bed request, overall percentage of admitted asthmatics, inpatient LOS, and percentage of pediatric intensive care unit (PICU) admissions. Methods This was a retrospective study of a quality improvement intervention. Statistical process control methodologies were used to analyze measures 15 months before and after implementation of a modified asthma pathway (June 2010 to December 2012; pathway modification September 2011). Results A total of 3,688 patients aged 1 through 18 years who presented to the ED with an asthma exacerbation during the study period were included. Patients were excluded if they were not eligible for the asthma pathway. Patient characteristics were similar before and after the intervention. Mean ED LOS and time to bed request for admitted asthmatics both decreased by 30 minutes. There was no change in percentage of asthma admissions (34%), mean inpatient LOS (1.4 days), or percentage of PICU admissions (2%). Conclusions Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow.

UR - http://www.scopus.com/inward/record.url?scp=84960426060&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960426060&partnerID=8YFLogxK

U2 - 10.1111/acem.12890

DO - 10.1111/acem.12890

M3 - Article

VL - 23

SP - 289

EP - 296

JO - Academic Emergency Medicine

JF - Academic Emergency Medicine

SN - 1069-6563

IS - 3

ER -