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

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.

In 2018, 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.

Our analysis 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, OSI scores increased on average one point for the assessment and monitoring of asthma severity, asthma control, and asthma action plans. Asthma education strategies were also associated with significantly greater odds of improvement in their respective clinical asthma management measures.

This project indicates 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.

Keywords: Quality improvement, primary care, learning collaborative, asthma control, asthma action plan

Stanley J. Weinberger, Kelly J. Cowan, Keith J. Robinson, Christine A. Pellegrino, Barbara L. Frankowski, Michael V. Chmielewski, Judith S. Shaw & Valerie S. Harder (2019) A primary care learning collaborative to improve office systems and clinical management of pediatric asthma, Journal of Asthma, DOI: 10.1080/02770903.2019.1702199