Use of a web-based pediatric asthma emergency department tracking system to improve physician asthma care and quality☆

Abstract 

Rationale

Asthma results in 570,000 emergency department visits for wheezing children less than fifteen years of age. It is critical to demonstrate that innovative tracking systems enhance quality asthma management in the emergency department setting.

Methods

A web based tracking system was developed and used to track quality indicators of care delivery to pediatric patients presenting to 6 hospital emergency departments in a 5 county southeastern Wisconsin region. Physician specific indicators of providing written care plans, steroid administration during the ED visit, and determination of chronic severity of asthma in patients were tracked before and after education intervention. Process improvement indicators of teaching spacer device usage and standard asthma video education for patients and family were tracked. Graphic feedback was given repetitively to physicians and emergency rooms to enhance adherence to standard care.

Results

Utilization of a web based tracking system to provide feedback to physicians and Emergency Departments resulted in major improvement. Spacer device teaching increased from 18% - 60%, determination of asthma severity increased from 44% to as high as 95%, and utilization of video teaching increased from 32% to a high of 84%. Written asthma care plans improved from 50% to 85%. Steroid use increased from 64% to 81% over a year.

Conclusions

A web based tracking system improves asthma care delivery in the ED through physician and department feedback.

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