Asthma Outcomes Pathway

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Asthma Outcomes Pathway

• Lori Palensky
• Saint Elizabeth Foundation
• Lincoln, NE
• 9.14.09

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A-S-T-H-M-A

• www.Bing.com says
• Asthma is a predisposition to chronic
  inflammation of the lungs in which the airways
  (bronchi) are reversibly narrowed. Asthma affects
  7 of the population, and 300 million worldwide.

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BACKGROUND OF ASTHMA

• Devastating chronic disease
• Public impact has increased over the last two
  decades

• Qualifies as a public health epidemic
• Nebraska-2

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COMMUNITY ASTHMA EDUCATION INITIATIVE - CAEI

• CAEI launched in 1998 at Saint Elizabeth Regional
  Medical Center-
• Funding-
• Asthma Coordinator
• 30 Agencies -

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CAEI Management of Asthma

• 1. Healthcare Provider Education Pyramid
• 2. Family Asthma Adventure
• 3. Pharmacist Intervention
• 4. Asthma Awareness
• 5. Asthma Surveillance
• Developed to bridge the
• patient-provider communication gap.

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FUNDERS THROUGH THE YEARS

• Saint Elizabeth Regional Medical Center
• Pharmaceutical
• EPA
• Private and Community Based Organizations

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ASTHMA OUTCOMES PATHWAY

• Catholic Health Initiative
• Mission Ministry Fund through the
• Saint Elizabeth Foundation

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Asthma Outcomes Pathways

• 1. Task Force formed
• 2. AHRQ Face-to-Face
• 3. Recruit partners-form
• liaison with
• ED Connection
• 4. Work groups assemble pathway technical
  assistance Dr. Redding
• 5. Define barriers and embed into pathways
  process

• 6. Determine outcome measures specific to
  intervention
• 7. Finders and connectors trained with referral
  mechanism
• 8. Develop return on investment, and create audit
  system
• 9. Begin documenting
• 10. Build system for review and
• quality assurance

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ASTHMA PATHWAYOutreachIdentify Patients Most
at RiskAgeCensus Tract NESWSocioeconomic
StatusRaceNumbersNo Medical Home ?
AssessmentBegin Asthma Action
Plan(Intervention/Identification) ?
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ASTHMA PATHWAY CONTINUEDIntervention
Specific-Education Referral

• Barrier Barrier Barrier
• Reduction Reduction Reduction
• ? ? ?
• Environmental Medical Home Medical Management
• Assessment Review
• ? ? ?
• Outcome Outcome Outcome
• Finalize Asthma Action Plan
• ?
• Follow-up
• Short term Outputs
• Long term Clinical methods

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Penelope

• Web-based case management
• Provides connectivity for Head Start school
  nurses and ED case managers
• Utilizes customized care algorithms
• Prints vouchers and maintains inventory of funds
• Stores data for outcomes and reporting

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Case Managers

• Outcomes Pathways streamlines their workload
  using algorithms for protocols and readily
  available vouchers for barrier reduction
• These finders are familiar and trusted by the
  target group
• These finders are invested in the target groups
  and in connections for barrier reduction
• Penelope connects Head Start, schools and
  Emergency Departments

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How is this improving access?

• The medical community becomes accountable to each
  other it takes a village approach
• Bridges the communication gap
• Provides an evidence based program
• A kinder and gentler approach for
• health care with the indigent.

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Outcomes

• Reduced duplication of services
• Unites at-risk population to evidence based
  intervention
• Identify and overcome barriers to care
• Reduces exacerbation through asthma management
  education
• Reduced number of sick days at school and work
• Number of symptom free days increase
• Decrease recurrent visits in Emergency
  Departments

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Asthma Outcomes PathwayFuture

• Continue to add to the number of Outcomes Asthma
  Pathways
• Foster and maintain relationships with community
  partners
• Once the pediatrics population is saturated
  develop the second pathway for the elderly
  population
• Share and mentor other communities in Nebraska.

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Thank You,for your time.

• For more information
• Saint Elizabeth Foundation
• 6900 L Street, Suite 100
• Lincoln, NE 68510
• 402.219.7051
• LPalensky_at_stez.org
• http//www.SaintElizabethOnline.com

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