Asthma clinic improves triage from emergency department to primary care

An express clinic implemented in the ED can help bridge the gap to primary care after acute asthma exacerbations.

Asthma clinic improves triage from ED to primary care
Asthma clinic improves triage from ED to primary care

LAS VEGAS — As many as 22 million U.S. emergency department visits annually are attributable to acute asthma exacerbations in children aged 15 years and younger, and rates for primary care follow-up visits in the week after such events are poor.

Only about 45% of children who visit the emergency department (ED) for an asthma attack make it to their primary care provider's office in the recommended five-to-seven day window after visiting urgent care.

A new pilot study examining the efficacy of an asthma express clinic underway at Johns Hopkins University in Baltimore, Maryland, is aiming to change that, according to two researchers at the National Association of Pediatric Nurse Practitioners 2015 meeting.

“Asthma is a big burden on a family. Since these families are comfortable coming in to the ED for care, they me be comfortable coming back for follow-up as well. Then we take it a step further and link these patients back to their primary care provider,” said Shawna Mudd, DNP, CPNP-AC, PNP-BC, an assistant professor in the department of acute and chronic care at the university told The Clinical Advisor.

The idea builds on the IMPACT DC model developed by Stephan J. Teach, MD, MPH, of Children's National Health System in Washington, DC, that strives to improve coordination between primary care providers, schools, and the community to reduce asthma-related ED visits and hospitalizations.

So far, Mudd and principle investigator Arlene Butz, ScD, RN, CRNP, of Johns Hopkins Children's Center, have recruited about half of the patients needed to meet their enrollment goal of 260 patients.

Patients who visit the ED at Johns Hopkins with at least two acute asthma exacerbations in the past year are recruited into the study and randomly assigned to a follow-up visit in the ED one week later with home visits, or a control group of home visits alone.

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