Collaborative quality improvement initiative to enhance adult asthma management.

Abstract

Background: Adult asthma is a prevalent chronic condition that is suboptimally managed in primary care settings.

Local problem: Uncontrolled asthma rates were noted in our local clinic where adult patients with asthma receive care.

Methods: We used a structured intervention to improve adult asthma management, with the primary objective of increasing the percentage of patients at our clinic with an updated Asthma Action Plan (AAP) during a 1-year period. Data were collected through electronic health record audits and patient surveys and were analysed by using run charts. This quality improvement initiative was based on the chronic care model, which emphasises self-management support, clinical decision support and clinic systemic changes.

Intervention: An approach involving a multidisciplinary team (ie, clinicians, nurses, panel managers and front desk personnel) was used to increase the percentage of adult patients (18-50 years old) at our clinic with an updated AAP (ie, reviewed within the past 12 months). The 1-year intervention period was from February 2023 through January 2024. The nursing team reviewed patients' problem lists to ensure updated information. In addition, the Asthma Management Questionnaire and Asthma Control Test were pushed through the patient portal for previsit completion or were administered during the rooming process by nursing staff. During the visit, clinicians followed up with patients to complete an AAP.

Results: Adherence to asthma management guidelines was improved during the intervention period. The percentage of patients with updated AAPs increased from 7.5% (n=120) in February 2023 to 43.4% (n=152) in January 2024. The percentage of patients with optimal asthma control also increased from 40.0% (n=120) in February 2023 to 55.2% (n=165) in August 2023 and 66.4% (n=152) in January 2024.

Conclusions: This quality improvement project led to measurable improvements in asthma care, highlighting the effectiveness of a structured intervention in the primary care setting.