Asthma clinic improves triage from emergency department to primary care

So far the preliminary results are promising. Children in the intervention group have a follow-up rate of 59% to 70% compared with children who undergo home visits only and 83% received at least one home visit.

“I think the appeal is that the clinic takes place in the evening hours. Parents can bring their children after work, and it’s a quick 20-minute visit,” Butz said. “They’re in and they’re out. We greet the patients in the lobby and take them right back. We do a quick assessment, education, we go over medications and then they’re out of there.”

“I think the rate is up because of accessibility and convenience,” Mudd added. “These patients have just had an acute asthma exacerbation. The child is sick, so it’s still in the parents’ head. Trying to get an appointment with primary care providers can take weeks, and the child is better by then.”

In addition to conducting the initial follow-up visit, the asthma express clinic performs remediate positive allergen sensitization testing (RAST), motivational interviewing and links patients back to their primary care provider. 

The asthma express clinic sends a letter to each patient’s primary care provider with allergy test results and patient recommendations.

“If primary care providers know what the child is allergic to then they can better target patient education efforts,” Butz said. “If the provider doesn’t know what a child is allergic to, asthma education is comprehensive, but it’s also broad and general. This program helps them target intervention and treatment. 

Study endpoints for the final data include reduction in ED visits, symptom days, hospitalizations, and controller and rescue medication use. A cost-effectiveness analysis to assess time parents miss from work and medication costs is also planned.

“We don’t want to take the children away from the primary care provider. This is really designed to bridge the gap to primary care to provide some needed follow-up shortly after the acute exacerbation and assist the primary care provider in further management,” Mudd emphasized.