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Electronic Asthma Action Plan Implementation to Improve Pediatric Asthma Management

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2023-05
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Problem & Purpose: Guidelines released by the Global Initiative for Asthma (GINA) in 2021 state that asthma action plans (AAPs) are essential to effective management for asthmatic patients to prevent, recognize, and treat exacerbations. The utilization of AAPs has been supported in the literature to help prevent negative exacerbation-related outcomes. At an outpatient pediatric pulmonology clinic at a large university medical center and its three satellite community clinics, patients received asthma management instructions in a written paragraph format. Routine provider usage of AAPs was at 0%. The purpose of this quality improvement initiative was to implement routine usage of electronic asthma action plans (eAAPs) for all clinic patients diagnosed with asthma to improve pediatric asthma management. Methods: During the 15-week implementation period, providers used a smart phrase to populate the eAAP into visit notes for all patients with a diagnosis of asthma. Data collection occurred weekly via chart audits. Rates on eAAP usage, oral steroid prescriptions, and asthma-related emergency room visits were collected and analyzed using run charts to detect trends over time. Compliance with eAAP usage was encouraged using email updates, site visits, and reference cards. Results: The weekly asthma action plan usage rates ranged from 4 to 66% during the implementation period. Oral steroid prescriptions fluctuated between 0 to 29% and asthma-related emergency room visits ranged from 0 to 35% throughout implementation in the fall season. Conclusions: Findings suggest that implementation of eAAPs increased asthma action plan usage at an outpatient pediatric pulmonology clinic and its satellite community clinics, fostering improved pediatric asthma self-management for patients and families. Sustainability efforts will focus on improving template usability in the electronic health record and exploring methods for increasing engagement from patients and families to further encourage eAAP use.

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