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Recertification program improved asthma care in children

An asthma quality improvement project designed for maintenance of certification improved the process of care for children with persistent asthma, according to recent research results.

The project to meet recertification requirements and improve asthma care was designed within the Pediatric Physicians’ Organization at Children’s, an independent practice associated with Boston Children’s Hospital. Researchers developed practice-based registries of children aged 5 to 17 years with persistent asthma. Education, data feedback and sharing of best practices were used to help physicians improve asthma care processes.

Along with 594 patients, 56 physicians participated and were divided into three cohorts based on dates of American Board of Pediatrics (ABP) recertification.

The use of the action plans showed improvement in all cohorts, including 62.4% to 76.8%, cohort 1; 50.6% to 88.4%, cohort 2; and 53% to 79.6%, cohort 3. Asthma Control Tests also produced improvement in cohort 1, 4.6% to 55.2%; cohort 2, 9% to 67.8%; and cohort 3, 15.2% to 61.4%.

Seasonal influenza vaccines, controller medications and asthma follow-up visits had “less consistent improvements.”

All cohorts showed a decline in the proportion of patients experiencing at least one asthma exacerbation within 1 year (37.8% to 19.9%, P=.0002, cohort 1; 27.8% to 20.7%, P=.1, cohort 2; 36.6% to 26.9%; P=.1, cohort 3).

“For each cohort, asthma exacerbations declined to a greater extent than those of a comparison group,” the researchers reported.

“The asthma QI [quality improvement] project demonstrated that an ABP-approved project based on practice-based registries and a learning collaborative approach can improve processes of care among patients with persistent asthma while allowing physicians to obtain necessary [maintenance of certification] credits, albeit with a substantial investment of organizational time and effort,” the researchers concluded. “Because of its success, we have expanded this model to other areas of QI and have made it our organization’s central approach to practice-based management.”

Disclosure: The researchers report no relevant financial disclosures.