Asthma Outcomes Pathway
Lori PalenskyLori PalenskySaint Elizabeth FoundationSaint Elizabeth Foundation
Lincoln, NELincoln, NE9.14.099.14.09
A-S-T-H-M-AA-S-T-H-M-A www.Bing.com says…www.Bing.com says…
AsthmaAsthma is a predisposition to chronic is a predisposition to chronic inflammation of the lungs in which the inflammation of the lungs in which the airways (bronchi) are reversibly airways (bronchi) are reversibly narrowed. Asthma affects 7% of the narrowed. Asthma affects 7% of the population, and 300 million worldwide. population, and 300 million worldwide.
BACKGROUND OF ASTHMABACKGROUND OF ASTHMA
Devastating Devastating chronic diseasechronic disease
Public impact Public impact has increased has increased over the last two over the last two decadesdecades
Qualifies as a Qualifies as a public health public health epidemicepidemic
Nebraska-#2Nebraska-#2
COMMUNITY ASTHMA COMMUNITY ASTHMA EDUCATION INITIATIVEEDUCATION INITIATIVE - - CAEICAEI
CAEI launched in 1998 at Saint Elizabeth CAEI launched in 1998 at Saint Elizabeth Regional Medical Center- Regional Medical Center-
Funding-Funding-
Asthma Coordinator Asthma Coordinator
30 Agencies - 30 Agencies -
CAEI Management CAEI Management of Asthmaof Asthma
1. Healthcare Provider Education Pyramid1. Healthcare Provider Education Pyramid
2. Family Asthma Adventure2. Family Asthma Adventure
3. Pharmacist Intervention3. Pharmacist Intervention
4. Asthma Awareness4. Asthma Awareness
5. Asthma Surveillance5. Asthma Surveillance
Developed to bridge the patient-provider communication gap.
FUNDERS THROUGH FUNDERS THROUGH THE YEARSTHE YEARS
Saint Elizabeth Regional Medical Saint Elizabeth Regional Medical CenterCenter
Pharmaceutical Pharmaceutical EPAEPA Private and Community Based Private and Community Based
OrganizationsOrganizations
ASTHMA ASTHMA OUTCOMES PATHWAYOUTCOMES PATHWAY
Catholic Health Initiative – Catholic Health Initiative –
Mission & Ministry Fund through the Mission & Ministry Fund through the
Saint Elizabeth Foundation Saint Elizabeth Foundation
Asthma Outcomes PathwaysAsthma Outcomes Pathways
1. Task Force formed2. AHRQ Face-to-Face3. Recruit partners-form
liaison with ED Connection
4. Work groups assemble pathway – technical assistance Dr. Redding
5. Define barriers and embed into pathways process
6. Determine outcome measures specific to intervention
7. Finders and connectors trained with referral mechanism
8. Develop return on investment, and create audit system
9. Begin documenting
10. Build system for review and quality assurance
ASTHMA PATHWAYASTHMA PATHWAY
OutreachOutreachIdentify Patients Most at RiskIdentify Patients Most at Risk
AgeAgeCensus Tract NESWCensus Tract NESW
Socioeconomic StatusSocioeconomic StatusRaceRace
NumbersNumbersNo Medical HomeNo Medical Home
AssessmentAssessmentBegin Asthma Action PlanBegin Asthma Action Plan(Intervention/Identification)(Intervention/Identification)
ASTHMA PATHWAY CONTINUEDASTHMA PATHWAY CONTINUED
Intervention Specific-Education & ReferralIntervention Specific-Education & Referral
Barrier Barrier BarrierBarrier Barrier Barrier
ReductionReduction Reduction Reduction ReductionReduction
EnvironmentalEnvironmental Medical HomeMedical Home Medical Medical
ManagementManagementAssessmentAssessment Review Review
OutcomeOutcome OutcomeOutcome OutcomeOutcome
Finalize Asthma Action PlanFinalize Asthma Action Plan
Follow-upFollow-up Short term – OutputsShort term – Outputs
Long term – Clinical methodsLong term – Clinical methods
““Penelope”Penelope” Web-based case managementWeb-based case management
Provides connectivity for Head Start school Provides connectivity for Head Start school nurses and ED case managersnurses and ED case managers
Utilizes customized care algorithmsUtilizes customized care algorithms
Prints vouchers and maintains inventory of fundsPrints vouchers and maintains inventory of funds
Stores data for outcomes and reportingStores data for outcomes and reporting
Case ManagersCase Managers Outcomes Pathways streamlines their workload using Outcomes Pathways streamlines their workload using
algorithms for protocols and readily available algorithms for protocols and readily available vouchers for barrier reductionvouchers for barrier reduction
These “finders” are familiar and trusted by the target These “finders” are familiar and trusted by the target groupgroup
These “finders” are invested in the target groups and These “finders” are invested in the target groups and in connections for barrier reduction in connections for barrier reduction
Penelope connects Head Start, schools and Penelope connects Head Start, schools and Emergency Departments Emergency Departments
How is this How is this improving access?improving access?
• The medical community becomes accountable The medical community becomes accountable to each other – ‘ it takes a village approach’ to each other – ‘ it takes a village approach’
• Bridges the communication gap Bridges the communication gap
• Provides an evidence based programProvides an evidence based program
• A kinder and gentler approach for A kinder and gentler approach for health care with the indigent. health care with the indigent.
Outcomes Reduced duplication of servicesReduced duplication of services Unites at-risk population to evidence based Unites at-risk population to evidence based
interventionintervention Identify and overcome barriers to careIdentify and overcome barriers to care Reduces exacerbation through asthma Reduces exacerbation through asthma
management educationmanagement education Reduced number of sick days at school and workReduced number of sick days at school and work Number of symptom free days increaseNumber of symptom free days increase Decrease recurrent visits in Emergency Decrease recurrent visits in Emergency
DepartmentsDepartments
Asthma Outcomes PathwayAsthma Outcomes PathwayFutureFuture
Continue to add to the number of Outcomes Continue to add to the number of Outcomes Asthma PathwaysAsthma Pathways
Foster and maintain relationships with community Foster and maintain relationships with community partnerspartners
Once the pediatrics population is saturated Once the pediatrics population is saturated develop the second pathway for the elderly develop the second pathway for the elderly populationpopulation
Share and mentor other communities in Share and mentor other communities in Nebraska. Nebraska.
Thank You,for your time.
For more information:
Saint Elizabeth Foundation6900 ‘L’ Street, Suite 100
Lincoln, NE 68510 402.219.7051
[email protected] http://www.SaintElizabethOnline
.com
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