PT  - JOURNAL ARTICLE
AU  - Schonlau, Matthias
AU  - Mangione-Smith, Rita
AU  - Chan, Kitty S.
AU  - Keesey, Joan
AU  - Rosen, Mayde
AU  - Louis, Thomas A.
AU  - Wu, Shin-Yi
AU  - Keeler, Emmett
TI  - Evaluation of a Quality Improvement Collaborative in Asthma Care: Does it Improve Processes and Outcomes of Care?
AID  - 10.1370/afm.269
DP  - 2005 May 01
TA  - The Annals of Family Medicine
PG  - 200--208
VI  - 3
IP  - 3
4099  - http://www.annfammed.org/content/3/3/200.short
4100  - http://www.annfammed.org/content/3/3/200.full
SO  - Ann Fam Med2005 May 01; 3
AB  - PURPOSE We wanted to examine whether a collaborative to improve asthma care influences process and outcomes of care in asthmatic adults. METHOD We undertook a preintervention-postintervention evaluation of 185 patients in 6 intervention clinics and 3 matched control sites that participated in the Institute for Healthcare Improvement Breakthrough Series (BTS) Collaborative for asthma care. The intervention consisted of 3, 2-day educational sessions for teams dispatched by participating sites, which were followed by 3 action periods during the course of a year. RESULTS Overall process of asthma care improved significantly in the intervention compared with the control group (change of 10% vs 1%, P = .003). Patients in the intervention group were more likely to attend educational sessions (20% vs 5%, P = .03). Having a written action plan, setting goals, monitoring peak flow rates, and using long-term asthma medications increased between 2% and 19% (not significant), but asthma-related knowledge was unchanged for the 2 groups. Patients in the BTS Collaborative were significantly more likely to be satisfied with clinician and lay educator communication (62% vs 39%, P = .02). Health-related quality of life, asthma-specific quality of life, number of bed days caused by asthma-related illness, and acute care service use were not significantly different between the 2 groups. CONCLUSIONS The intervention was associated with improved process-of-care measures that have been linked with better outcomes. Patients benefited through increased satisfaction with communication. Follow-up of patients who participated in the intervention may have been too brief to be able to detect significant improvement in health-related outcomes.