From the Journals

Partnerships with pediatric tertiary care centers improve community ED asthma treatment

Publish date: December 8, 2016
By
Lucas Franki
MDedge News

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The next steps for ED therapy
Susan Millard, MD, FCCP

Dr. Walls and her group developed a quality improvement (QI) initiative with a community emergency department. One important part of the study was the use of an asthma score, which helped determine steps for ED therapy.

Dr. Susan Millard

Dr. Susan Millard

They found great results in the large number of study patients who were treated for asthma acutely at the community ED after the QI project was implemented. It would be great if the next step in the collaboration would be education for when to start inhaled steroids on patients with persistent asthma to decrease emergency room utilization!


 

FROM PEDIATRICS

Partnerships between community emergency departments and pediatric tertiary care centers are feasible and improve care of pediatric asthma, according to Theresa A. Walls, MD, of the Children’s National Health Systems, Washington, D.C., and her associates.

A total of 724 asthma patients aged 2-17 years were included in the study. Of this group, 289 (40%) were treated at the community ED before the pediatric tertiary care center intervention and 435 (60%) were treated after the intervention. Treatment with steroids was significantly increased post intervention, with 76% of patients receiving steroids, compared with 60% of patients before the intervention.

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Time to steroids was significantly reduced after intervention, falling from 196 minutes to 105 minutes. No significant difference was seen in the number of returns, but the number of transfers was reduced to 10% after intervention, falling from 14%.

“Because the overwhelming majority of pediatric emergency visits occur in community EDs, partnerships with these EDs can broaden the impact of quality improvement activities and should be part of future quality improvement efforts,” the investigators concluded.

Find the full study in Pediatrics (2016. doi: 10.1542/peds.2016-0088).

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