Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: Washington, DC
IMPACT DC: Improving Pediatric Asthma Care in the District of Columbia
Children's Research Institute
Stephen J. Teach, MD, MPH
IMPACT DC: Improving Pediatric Asthma Care in the District of Columbia began in 2001 and is managed by the Children's Research Institute in Washington, DC. The program aims to perform ongoing surveillance of pediatric asthma and emergency department (ED) visits, decrease asthma-related ED visits, increase scheduled office visits and reduce morbidity and improve quality of life for children with asthma.
Urban, low-income children aged one to 18 years who present at an ED return to the ED for a non-emergency follow-up visit with the physician. The doctor who saw the patient at the prior ED visit, with both the child and the family, conducts the follow-up visit which lasts 60-90 minutes. During the visit, doctors provide medical care including an asthma action plan, environmental trigger control recommendations and care coordination.
ED doctors receive training by a physician in order to improve the asthma care offered in the initial and non-emergency follow-up visits. These education sessions last one-hour and occur once yearly.
The evaluation for the period of April 2002- September 2004 revealed that IMPACT DC had a positive impact on the following health outcomes: hospitalizations, ED visits, urgent care visits, unscheduled (sick) visits, scheduled (well) visits, school absences, quality of life for children, symptoms, medication use, change in clinical action (provider behavior), functional status, lung function, self-management skills, and use of an asthma action plan.
An unintended impact of the program has been improved asthma care by community doctors through modeling. The program is ongoing and replication efforts are in progress.
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