Decreasing Healthcare Utilization with Parent/Caregiver Asthma Education: An Evidence-Based Practice Improvement Project in Pediatric Primary Care

BACKGROUND: Asthma in children under 18 years old remains a significant health issue in the United States. It is the leading cause of missed school days and is responsible for increased healthcare utilization annually including emergency department visits, office visits, and hospitalizations. Parents and caregivers of these children must have the knowledge and understanding of how to effectively manage the illness.

LOCAL PROBLEM: The setting for this project was a pediatric primary care department in a large physician group in middle Tennessee. The site did not have a standardized approach for providing asthma education. Literature supported implementation of face-to-face education to decrease healthcare utilization. The purpose was to implement a detailed asthma education process for parents/caregivers of children with asthma and increase their confidence to manage their child’s asthma, with a specific aim to decrease healthcare utilization for asthma by 25%.

METHODS: The framework for this project was the Evidence-Based Practice Improvement (EBPI) model. Data was collected pre- and post-education to evaluate healthcare utilization and parental confidence.

INTERVENTIONS: Following referral from the provider, parents/caregivers received an asthma education intervention provided by trained clinical staff that included face-to-face instruction and written materials.

RESULTS: Eight participants received the full educational intervention. Three parents (37.5%) reported their child having one or more office visits for asthma pre-education and no office visits were reported three months post-education. There was an increase in parent/caregiver confidence from pre-education baseline measure to 1 week post-education, with the confidence levels maintained at three months.

CONCLUSIONS: Implementation of a parent/caregiver focused asthma education intervention had a clinically significant decrease in office visits for asthma and statistically significant increase in parent/caregiver confidence in their ability to manage their child’s asthma. A sustainability plan includes training a “champion” who will train others and maintain the process, providing a standardized approach to asthma education in this pediatric practice.