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Asthma Health Outcomes Project

Overviews of Surveyed Asthma ProgramsSeptember 2005

Domestic Programs: HawaiiBack to Index

Managing Pediatric Asthma: Emergency Department Demonstration Program: Hawaii CARES (Child Asthma Research to Elevate Standards)

Kapi'olani Health Foundation

Honolulu, HI

Charles DeMesa, MPH

(808) 983-6091         



"Managing Pediatric Asthma: Emergency Department Demonstration Program: Hawaii CARES (Child Asthma Research to Elevate Standards)" is a Robert Wood Johnson Foundation program that seeks to reduce asthma-related visits to emergency departments, increase reliance on primary care providers, improve adherence to clinical protocols, and improve patient knowledge of and compliance with therapeutic regimens. The program targets children one to 17 years at-risk for severe asthma and poor asthma care. The Hawaii CARES program is one of four sites nationwide (including DC, Texas, and Wisconsin). Hawaii CARES is comprised of four hospitals on Oahu.

Hawaii CARES emphasizes a multi-pronged approach to asthma care including: (1) prospective tracking of ED asthma patients; (2) an ED-based educational intervention for asthma patients and families; and (3) an asthma education program for ED staff and community-based healthcare providers.

A team of ED and community-based healthcare professionals developed strategies for building an integrated asthma care system throughout the island of Oahu. The project delivered ED staff asthma training and conducted continuing medical education programs for community-based healthcare providers. The fundamental learning objectives included the importance of compliance with NAEPP asthma care guidelines, the asthma chronic severity classification system and its use for treating patients, and the importance of long-term controller medications and written asthma action plans.

After providing community-based education sessions and integrating recommendations and input into ED-based asthma care from community providers, the Hawaii CARES program deployed the multi-center, ED-based educational intervention for patients with asthma and their families. The education component was intended to accommodate or appeal to children and families that have an assortment of learning styles.

ED staff provided community physicians with tools to facilitate a patient’s ED follow-up visit. Following an ED visit, the patient’s physician was provided with information regarding the asthma ED visit, including information ion the medications and type(s) of asthma education the patient received, the patient’s chronic asthma severity classification, and a copy of the patient’s recommended discharge plan.  

The program has had a positive impact on quality of life, symptoms, medication use, and use of an asthma action plan. Hawaii CARES continues with additional grant funding and dissemination of the program is in progress.

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