Improvement of Hospital management of Asthma and COPD exacerbation

Improvement Objective: Decrease asthma/COPD morbidity and mortality in affected adults and children through improved quality of asthma/COPD case-management (hospital)

Key Interventions:

  • Immediate triage of patients suspected or confirmed with Asthma or COPD exacerbation (shortness of breath, wheezing, respiratory distress etc.)
  • Assessment and classification of severity status of exacerbation
  • hospital management of exacerbation:
    • Oral or IV steroid
    • Nebulized bronchodilator
    • Oxygen if needed
    • + Antibiotic for COPD: if patient has sputum purulence,  increased sputum volume or dyspnea; or is on mechanical ventilation
  •  Assessment of COPD severity/Asthma status
  • Assessment of spirometry status
  • Identification & control triggers & risk factors
  • Patient self-management support
  • Follow-up time & place

Printable and downloadable versions

 

 

Routine indicators for monitoring quality of care

Process

  • AH-P1   Initial evaluation:  % pts. hosptialized for  asthma or COPD exacerbation with VS documented at admission
  • AH-P2   % patients hospitalized for asthma or COPD with severity classification documented
  • AH-P3   % of patients hospitalized for asthma or COPD exacerbation in whom oxygen is administered if indicated
  • AH-P4   % patients hospitalized for asthma or COPD exacerbation started on  oral steroid  day of admission
  • AH-P5   % patients hospitalized with asthma or COPD exacerbation treated with repeated nebulizer treatments
  • AH-P6   Average # of non-EBM medications administered per asthma/COPD patients
  • AH-P7   % patients hospitalized for asthma or COPD with spirometry testing to assess severity prior to discharge
  • AH-P8   Discharge:  % patients hospitalized for asthma or COPD discharged home with bronchodilator treatment
  • AH-P9   % patients hospitalized for asthma or COPD discharged home on controller (preventive) treatment
  • AH-P10 % patients hospitalized for Asthma or COPD with standard discharge  form completed

OUTCOME

  • AH-O1   Re-admission rate within 30 days
  • AH-O2   In hospital mortality
  • AH-O3   Total # of hospitalization days