TY - JOUR
T1 - Evaluation of a quality improvement collaborative in asthma care
T2 - Does it improve processes and outcomes of care?
AU - Schonlau, Matthias
AU - Mangione-Smith, Rita
AU - Chan, Kitty S.
AU - Keesey, Joan
AU - Rosen, Mayde
AU - Louis, Thomas A.
AU - Wu, Shin Yi
AU - Keeler, Emmett
PY - 2005/5
Y1 - 2005/5
N2 - PURPOSE: We wanted to examine whether a collaborative to improve asthma care influences process and outcomes of care in asthmatic adults. METHOD: We undertook a preintervention-postintervention evaluation of 185 patients in 6 intervention clinics and 3 matched control sites that participated in the Institute for Healthcare Improvement Breakthrough Series (BTS) Collaborative for asthma care. The intervention consisted of 3, 2-day educational sessions for teams dispatched by participating sites, which were followed by 3 action periods during the course of a year. RESULTS: Overall process of asthma care improved significantly in the intervention compared with the control group (change of 10% vs 1%, P = .003). Patients in the intervention group were more likely to attend educational sessions (20% vs 5%, P = .03). Having a written action plan, setting goals, monitoring peak flow rates, and using long-term asthma medications increased between 2% and 1.9% (not significant), but asthma-related knowledge was unchanged for the 2 groups. Patients in the BTS Collaborative were significantly more likely to be satisfied with clinician and lay educator communication (62% vs 39%, P = .02). Health-related quality of life, asthma-specific quality of life, number of bed days caused by asthma-related illness, and acute care service use were not significantly different between the 2 groups. CONCLUSIONS: The intervention was associated with improved process-of-care measures that have been linked with better outcomes. Patients benefited through increased satisfaction with communication. Follow-up of patients who participated in the intervention may have been too brief to be able to detect significant improvement in health-related outcomes.
AB - PURPOSE: We wanted to examine whether a collaborative to improve asthma care influences process and outcomes of care in asthmatic adults. METHOD: We undertook a preintervention-postintervention evaluation of 185 patients in 6 intervention clinics and 3 matched control sites that participated in the Institute for Healthcare Improvement Breakthrough Series (BTS) Collaborative for asthma care. The intervention consisted of 3, 2-day educational sessions for teams dispatched by participating sites, which were followed by 3 action periods during the course of a year. RESULTS: Overall process of asthma care improved significantly in the intervention compared with the control group (change of 10% vs 1%, P = .003). Patients in the intervention group were more likely to attend educational sessions (20% vs 5%, P = .03). Having a written action plan, setting goals, monitoring peak flow rates, and using long-term asthma medications increased between 2% and 1.9% (not significant), but asthma-related knowledge was unchanged for the 2 groups. Patients in the BTS Collaborative were significantly more likely to be satisfied with clinician and lay educator communication (62% vs 39%, P = .02). Health-related quality of life, asthma-specific quality of life, number of bed days caused by asthma-related illness, and acute care service use were not significantly different between the 2 groups. CONCLUSIONS: The intervention was associated with improved process-of-care measures that have been linked with better outcomes. Patients benefited through increased satisfaction with communication. Follow-up of patients who participated in the intervention may have been too brief to be able to detect significant improvement in health-related outcomes.
KW - Asthma
KW - Breakthrough series collaborative
KW - Chronic care model
KW - Chronic disease
KW - Evaluation studies
KW - Outcomes and process assessment (health care)
KW - Process of care
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U2 - 10.1370/afm.269
DO - 10.1370/afm.269
M3 - Article
C2 - 15928222
AN - SCOPUS:20444382750
SN - 1544-1709
VL - 3
SP - 200
EP - 208
JO - Annals of family medicine
JF - Annals of family medicine
IS - 3
ER -