RT Journal Article
SR Electronic
T1 Evaluation of a Quality Improvement Collaborative in Asthma Care: Does it Improve Processes and Outcomes of Care?
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 200
OP 208
DO 10.1370/afm.269
VO 3
IS 3
A1 Matthias Schonlau
A1 Rita Mangione-Smith
A1 Kitty S. Chan
A1 Joan Keesey
A1 Mayde Rosen
A1 Thomas A. Louis
A1 Shin-Yi Wu
A1 Emmett Keeler
YR 2005
UL http://www.annfammed.org/content/3/3/200.abstract
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.