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Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department.
Acad Emerg Med. 2016 Mar; 23(3):289-96.AE

Abstract

OBJECTIVES

Asthma is the most common chronic illness in children and accounts for > 600,000 emergency department (ED) visits each year. Reducing ED length of stay (LOS) for moderate to severe asthmatics improves ED throughput and patient care for this high-risk population. The objective of this study was to determine the impact of adding standardized, respiratory score-based admission criteria to an asthma pathway on ED LOS for admitted patients, time to bed request, overall percentage of admitted asthmatics, inpatient LOS, and percentage of pediatric intensive care unit (PICU) admissions.

METHODS

This was a retrospective study of a quality improvement intervention. Statistical process control methodologies were used to analyze measures 15 months before and after implementation of a modified asthma pathway (June 2010 to December 2012; pathway modification September 2011).

RESULTS

A total of 3,688 patients aged 1 through 18 years who presented to the ED with an asthma exacerbation during the study period were included. Patients were excluded if they were not eligible for the asthma pathway. Patient characteristics were similar before and after the intervention. Mean ED LOS and time to bed request for admitted asthmatics both decreased by 30 minutes. There was no change in percentage of asthma admissions (34%), mean inpatient LOS (1.4 days), or percentage of PICU admissions (2%).

CONCLUSIONS

Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow.

Authors+Show Affiliations

University of Washington, Seattle, WA. Seattle Children's Hospital, Seattle, WA.University of Washington, Seattle, WA. Seattle Children's Hospital, Seattle, WA.Seattle Children's Hospital, Seattle, WA.University of Washington, Seattle, WA. Seattle Children's Hospital, Seattle, WA.University of Washington, Seattle, WA. Seattle Children's Hospital, Seattle, WA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26728418

Citation

Rutman, Lori, et al. "Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 23, no. 3, 2016, pp. 289-96.
Rutman L, Migita R, Spencer S, et al. Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department. Acad Emerg Med. 2016;23(3):289-96.
Rutman, L., Migita, R., Spencer, S., Kaplan, R., & Klein, E. J. (2016). Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 23(3), 289-96. https://doi.org/10.1111/acem.12890
Rutman L, et al. Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department. Acad Emerg Med. 2016;23(3):289-96. PubMed PMID: 26728418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department. AU - Rutman,Lori, AU - Migita,Russell, AU - Spencer,Suzanne, AU - Kaplan,Ron, AU - Klein,Eileen J, Y1 - 2016/02/13/ PY - 2015/07/13/received PY - 2015/09/10/revised PY - 2015/10/11/accepted PY - 2016/1/6/entrez PY - 2016/1/6/pubmed PY - 2016/10/13/medline SP - 289 EP - 96 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 23 IS - 3 N2 - OBJECTIVES: Asthma is the most common chronic illness in children and accounts for > 600,000 emergency department (ED) visits each year. Reducing ED length of stay (LOS) for moderate to severe asthmatics improves ED throughput and patient care for this high-risk population. The objective of this study was to determine the impact of adding standardized, respiratory score-based admission criteria to an asthma pathway on ED LOS for admitted patients, time to bed request, overall percentage of admitted asthmatics, inpatient LOS, and percentage of pediatric intensive care unit (PICU) admissions. METHODS: This was a retrospective study of a quality improvement intervention. Statistical process control methodologies were used to analyze measures 15 months before and after implementation of a modified asthma pathway (June 2010 to December 2012; pathway modification September 2011). RESULTS: A total of 3,688 patients aged 1 through 18 years who presented to the ED with an asthma exacerbation during the study period were included. Patients were excluded if they were not eligible for the asthma pathway. Patient characteristics were similar before and after the intervention. Mean ED LOS and time to bed request for admitted asthmatics both decreased by 30 minutes. There was no change in percentage of asthma admissions (34%), mean inpatient LOS (1.4 days), or percentage of PICU admissions (2%). CONCLUSIONS: Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/26728418/Standardized_Asthma_Admission_Criteria_Reduce_Length_of_Stay_in_a_Pediatric_Emergency_Department_ L2 - https://doi.org/10.1111/acem.12890 DB - PRIME DP - Unbound Medicine ER -