The webinars were two complementary 90-minute sessions and were delivered in summer 2013. The first webinar, “Optimal Asthma Treatment in the Emergency Department,” focused specifically on best practices for care in emergency departments themselves. It covered EPR-3 recommended activities such as helping families create Asthma Action Plans and demonstrating proper inhaler technique. The second webinar, “Transitioning Asthma Care from the Emergency Department to Prevent Repeat Visits,” focused on strategies for preventing repeat visits with people who have been seen in the emergency department for asthma. It covered activities like creating linkages with primary and specialty care providers skilled in asthma care, and partnering with case management professionals to follow discharged patients over time. Both webinars emphasized strategies for consistently implementing and sustaining adherence to EPR-3 guidelines in emergency departments. Participants attended sessions from their offices or meeting rooms by logging onto the webinar in a browser window and dialing into the conference line. Full recordings of both sessions remain available online at http://floridaasthmacoalition.com/healthcare-providers/recorded-webinars/.
We evaluated the reach and effectiveness of the webinars [8]. Attendance was high, with 137 pre-registrants and many more participating. Over 90% of participants in each session rated the content and discussion as either very good or excellent, and at least 90% indicated that they would recommend the learning modules to their colleagues. Participants expressed strong interest in continuing the activities initiated with the web sessions on a year-round basis, with particular emphasis on partnership building, continuing education, and cooperative action.
Asthma-Friendly Homes Program
Data from our preliminary assessment of asthma management practices in Florida hospitals suggested that an important priority for improving emergency department asthma care is reducing repeat visits. Rates of repeated emergency department utilization for asthma management correlate inversely with both household income and quality of available resources for home self-management. Our team considered developing a home visiting program to bring asthma education programming and self-management tools to children and their families. Rather than trying to build a new program ourselves, we extended our focus on strategic partnership to the Florida department of health’s regional affiliate in Miami-Dade County, who were developing a home visiting intervention to reduce emergency department visits and improve continuity of care for children with asthma [9].
Early planning for the Miami-Dade program included a focus on low-income communities and households, including the homes of children with Latino and/or Haitian heritage. The Asthma-Friendly Homes Program was developed in partnership with Nicklaus Children’s Hospital, with the hospital and the local Department of Health affiliate sharing responsibility for program implementation and management as well as data collection [10]. Small adjustments were made to the overall program strategy as partner agencies began working with Florida Asthma Program managers and evaluators. Now in its second year of implementation, the Asthma-Friendly Homes Program continues to evolve and grow.
Preventing repeat visits to the emergency room in favor of daily self-management at home remains the central emphasis of the program. Its curriculum focuses on empowering children with asthma and their families to self-manage effectively and consistently. By consequence, the Asthma-Friendly Homes Program encourages patients to use emergency department care services only when indicated by signs and symptoms rather than as a primary source of care. To achieve these objectives, the program uses a combination of activities including home visits and regular follow-up by case management.