According to data published in Pediatrics, implementing standardized asthma scoring and timely beta-agonist administration could reduce ED length of stay and readmissions for pediatric patients with acute asthma exacerbations.
Researchers used a quality improvement method to target knowledge, engagement, decision support and workflow enhancement at The Children’s Hospital of Wisconsin’s tertiary pediatric ED. Patients included in the improvement effort were aged between 2 years and 18 years seen in the ED between May 2012 and November 2015. All patients received at least one SABA during ED visits. The researchers implemented time series analysis for SABA administration and ED length of stay, and recorded Pediatric Asthma Severity Scores were analyzed with p-charts.
Among 5,552 patient encounters in the ED during the study period, the Pediatric Asthma Severity Score was recorded in triage more than 95% for all 3 years. SABA administration in the first year improved by 33 minutes prior to improvement testing, and low asthma severity patients improved by 17.6 minutes. Time to first SABA in high severity patients improved by 3 to 18 minutes. Time to third SABA improved by 30 minutes, low severity patients improved by 42.5 minutes and high severity patients improved 21 minutes.