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Pediatric, community hospitals see significant long-term improvements through asthma evidence-based care process model

Implementation of an evidence-based care process model for pediatric patients with asthma helped to reduce readmissions, costs and length of stay at a primary children’s hospital and seven other community hospitals while also maintaining current resource levels, according to recent research published in Pediatrics.

“Our intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals,” Flory L. Nkoy, MD, MS, MPH, associate research professor of pediatrics at the University of Utah School of Medicine, and colleagues wrote.

Nkoy and colleagues measured the effects of an evidence-based care process model (EB-CPM) on patients with asthma aged between 2 and 17 years, according to the abstract. The model was adopted first at a primary children’s hospital in 2008 before researchers implemented it at a tertiary care center and seven community hospitals in 2011.

The researchers examined the pre-implementation and post-implementation periods for the model at each center and compiled a composite score to measure compliance as well as measuring factors such as readmission, length of stay and reduced costs.

Within the primary children’s hospital, compliance for the EB-CPM increased from 45% at baseline to over 90%, where it remained for over 5 years after implementation. Nkoy and colleagues also saw reductions in cost (P = .094), asthma readmission (P = .026) and length of stay (P < .001) as well as noting there was no change in resource use for the hospital, intensive care unit transfers or mortality rate.

Compliance for the other seven community hospitals was also high, increasing from a range of 25% and 58% at baseline to a range of 80% and 99% within 6 months of implementation. Among these centers, compliance remained at a range of 80% and 99% for more than 2 years while also seeing a significant reduction in cost (P = .053) and length of stay (P < .001). There was a slight reduction in asthma readmissions and a slight increase in hospital resource use, but no change in intensive care unit transfers or mortality rate, according to the abstract. – by Jeff Craven

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