RESULTS OF A PROGRAM TO IMPROVE THE PROCESS OF INPATIENT CARE OF ADULT ASTHMATICS

Objective: To assess the effectiveness of a program to improve care of adult patients hospitalized for asthma. Design: Retrospective analysi s of patient and house staff education, patterns of medication use, sp acer use, peak flowmeter use, and length of stay before and after team intervention. Setting: A 960-bed teaching hospital in New York City. Patients: All patients admitted to the hospital with a primary diagnos is of acute asthma exacerbation for 2 separate similar calendar period s, 1 year apart, before and after program intervention, We excluded pa tients who were hospitalized for less than 24 h or greater than 10 day s. The preintervention group comprised 61 patients and the postinterve ntion group 65 patients, well matched in their demographic characteris tics and severity of disease. Interventions: Using a team approach, we analyzed the process of inpatient treatment of asthma exacerbation, i dentified root causes for quality deficiency; and implemented specific improvements in the process, These included dedicated nurses who focu sed on the education of care providers and patients, a personalized at tending-intern educational approach, and improvement in the supply and delivery of spacers, peak flowmeters, and medications to the patients . Results: There was a significant increase in use of spacers, peak fl owmeters, and inhaled corticosteroids. Systemic corticosteroid and met hylxanthine use declined, Length of stay was reduced without increasin g earl, hospital readmission rates. Conclusions: This program improved the treatment process of adults hospitalized for asthma.