A primary care learning collaborative to improve office systems and clinical management of pediatric asthma.

Autor:	Weinberger SJ; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA.; Pediatric Primary Care, University of Vermont Children's Hospital, Burlington, VT, USA., Cowan KJ; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA.; Pediatric Pulmonology, University of Vermont Children's Hospital, Burlington, VT, USA., Robinson KJ; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA.; Pediatric Pulmonology, University of Vermont Children's Hospital, Burlington, VT, USA., Pellegrino CA; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA., Frankowski BL; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA.; Pediatric Primary Care, University of Vermont Children's Hospital, Burlington, VT, USA., Chmielewski MV; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA., Shaw JS; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA., Harder VS; Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA.
Jazyk:	angličtina
Zdroj:	The Journal of asthma : official journal of the Association for the Care of Asthma [J Asthma] 2021 Mar; Vol. 58 (3), pp. 395-404. Date of Electronic Publication: 2019 Dec 14.
DOI:	10.1080/02770903.2019.1702199
Abstrakt:	Objective: Pediatric asthma is a common, relapsing-remitting, chronic inflammatory airway disease that when uncontrolled often leads to substantial patient and health care system burden. Improving management of asthma in primary care can help patients stay well controlled. Methods: The Vermont Child Health Improvement Program (VCHIP) developed a quality improvement (QI) learning collaborative with a primary objective to improve clinical asthma management measures through improvement in primary care office systems to support asthma care. Seven months of medical record review data were evaluated for improvements on eight clinical asthma management measures. Pre and post office systems inventory (OSI) self-assessments detailing adherence to improvement strategies were analyzed for improvement. Logistic regressions were used to test for associations between OSI strategy post scores and the corresponding clinical asthma management measures by month seven. Results: This study found significant improvement from baseline to month seven on seven of the eight clinical asthma management measures and between pre and post OSI for seven of the nine strategies assessed ( N  = 19 practices). Additionally, one point higher average OSI scores on the assessment and monitoring of asthma severity, asthma control, asthma action plans, and asthma education strategies were associated with significantly greater odds of improvement in their respective clinical asthma management measures. Conclusions: A QI learning collaborative approach in primary care can improve office systems and corresponding clinical management measures for pediatric patients with asthma. This suggests that linking specific office systems strategies to clinical measures may be a helpful tactic within the learning collaborative model.
Databáze:	MEDLINE
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