The Journal of asthma : official journal of the Association for the Care of Asthma 2017 01 24() 0 doi 10.1080/02770903.2017.1281294
Asthma is the most common chronic disease of childhood, and a leading cause of hospitalization in children. A primary goal of asthma control is prevention of hospitalizations. A hospital admission is the single strongest predictor of future hospital admissions for asthma. The 30-day asthma readmission rate at our institution was significantly above that of other hospitals in the Children’s Hospital Association. As a result, a multi-faceted quality improvement project was undertaken with the goal of reducing the 30-day inpatient asthma readmission rate by 50% within two years.
Analysis of our institution’s readmission patterns, value stream mapping of asthma admission, discharge, and followup processes, literature review, and examination of comparable successful programs around the United States were all utilized to identify potential targets for intervention. Interventions were implemented in a step-wise manner, and included increasing inhaler availability after discharge, modifying asthma education strategies, and providing in home post-discharge followup. The primary outcome was a running 12-month average 30-day inpatient readmission rate. Secondary outcomes included process measures for individual interventions.
From a peak of 7.98% in January 2013, a steady decline to 1.65% was observed by July 2014, which represented a 79.3% reduction in 30-day readmissions.
A significant decrease in hospital readmissions for pediatric asthma is possible, through comprehensive, multidisciplinary quality improvement that spans the continuum of care.