Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: New York
Asthma Quality Improvement Project
New York State Department of Health, Office of Medicaid Management, Medicaid Fee-for-Service
Donna L. Haskin, BSN, RN
In October 2000, the Office of Medicaid Management of the New York State Department of Health, in conjunction with its contractor the Island Peer Review Organization, launched an Asthma Quality Improvement project, which is in its fifth year of operation. The main objective of this project is to improve the quality of asthma care rendered to New York State Medicaid fee-for-service recipients. The project is based on the Chronic Care Model to promote improvement in patient care (children and adults).
A major goal of this project is to facilitate productive interactions between an informed, activated patient and their prepared, proactive health care team. The component of greatest emphasis is provider education and feedback using peer report cards. Educational sessions, led by an RN, PA and MD are conducted at the 15 participating practices (usually 1-2 sessions per practice). An Asthma Toolkit is used in the educational sessions that consist of guidelines, flowcharts, reminder and severity stickers, asthma severity templates, treatment algorithms, and teaching tools on what to say to patients regarding the disease, treatment and triggers. Patient asthma self-management educational materials are provided to practices, as well as updates on asthma care in adult and pediatric populations. Teleconferences on disease management were also conducted among all the practices and are available online for providers (statewide) to obtain continuing medical education credits.
Of particular interest, areas in New York State known to have high prevalence rates of asthma are targeted. Clinics within a large provider group or practice in these areas are sought out in hopes that the providers will collaborate and share with each other the information provided in the quality improvement project. All the practices are volunteer participants.
Thirteen out of the original 15 practices were included in the 2002-2003 evaluation. The project yielded positive outcomes in medication use (long-term anti-inflammatory controller use), change in clinical action, and self-management skills.
This project has been recognized locally and nationally for its innovativeness and ability to forge relationships between public health staff, providers and patients. The staff's commitment and vision contributed to the project's initial and ongoing success. The current project has been expanded to include 20 downstate clinics and 5 upstate clinic sites. The project has been enhanced to include: 1) onsite asthma disease management training to clinic/health center staff; 2) onsite communication skills training; 3) office flow design and patient self-management training to staff; and 4) to assist with population of patient registries.
In conclusion, this project has been successful at achieving positive clinical outcomes and promoting overall health quality for Medicaid recipients known to have asthma.
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