Facilitating the Use of Asthma Action Plans in Primary Care: A Quality Improvement Project

Abstract

Asthma is a chronic respiratory disease affecting over 300 million individuals worldwide (Akinbami et al., 2012; Brashers, 2010). Despite increased knowledge regarding the mechanisms and pathophysiology of asthma and increased treatment options, the prevalence of asthma in the United States continues to rise (Akinbami et al., 2012). Evidence-based guidelines on the treatment and management of asthma have been available for over 20 years and the use of Asthma Action Plans (AAP) has been consistently recommended to provide patients with the self-management skills to control asthma symptoms. However, research has consistently demonstrated underutilized AAPs as a method to decrease asthma exacerbations. The purpose of this DNP project was to develop and implement a quality improvement (QI) initiative with Internal and Family Medicine in Mesa-Gilbert, Arizona that will improve asthma clinical management by providing the patient self-management skills needed to control the symptoms, prevent complications, and improve outcomes through the implementation of AAP standards for patients diagnosed with asthma. Using the Plan-Do-Study-Act (PDSA) method to promote quality improvement (QI), a root cause analysis was conducted to evaluate the current processes within the clinic. The QI team agreed upon a process change, which was implemented to promote the identification of patients with asthma so that an AAP could be implemented. The low rates of patients identified during the time period in which this QI project was conducted presented a limitation as to whether the process change was truly effective. This project discussed the process of QI using the PDSA Model for Improvement and need for evidence-based practice to promote improved patient outcomes. Further PDSA cycles and additional time are required to fully incorporate process change and to determine the effectiveness of the intervention.