Evaluation of a Quality Improvement Collaborative in Asthma Care
Does it Improve Processes and Outcomes of Care?
PURPOSE: The authors wanted to examine whether a collaborative to improve asthma care influences process and outcomes of care in asthmatic adults.
METHOD: They undertook a preintervention-postintervention evaluation of 185 patients in 6 intervention clinics and 3 matched control sites that participated in the Institute for Healthcare Improvement Breakthrough Series (BTS) Collaborative for asthma care. The intervention consisted of 3, 2-day educational sessions for teams dispatched by participating sites, which were followed by 3 action periods during the course of a year.
RESULTS: Overall process of asthma care improved significantly in the intervention compared with the control group (change of 10% vs 1%, P = .003). Patients in the intervention group were more likely to attend educational sessions (20% vs 5%, P = .03). Having a written action plan, setting goals, monitoring peak flow rates, and using long-term asthma medications increased between 2% and 19% (not significant), but asthma-related knowledge was unchanged for the 2 groups. Patients in the BTS Collaborative were significantly more likely to be satisfied with clinician and lay educator communication (62% vs 39%, P = .02). Health-related quality of life, asthma-specific quality of life, number of bed days caused by asthma-related illness, and acute care service use were not significantly different between the 2 groups.
CONCLUSIONS: The intervention was associated with improved process-of-care measures that have been linked with better outcomes. Patients benefited through increased satisfaction with communication. Follow-up of patients who participated in the intervention may have been too brief to be able to detect significant improvement in health-related outcomes.
Reprinted with permission from Annals of Family Medicine, Vol. 3, No. 3, May/June 2005, pp. 200-208. Copyright © 2005 Annals of Family Medicine, Inc.
- Copyright: RAND Corporation
- Publisher: Annals of Family Medicine, Inc.
- Availability: Web-Only
- Pages: 9
- Document Number: RP-1349
- Year: 2005
- Series: Reprints
Originally published in: Annals of Family Medicine, Vol. 3, No. 3, May/June 2005, pp. 200-208.
This report is part of the RAND Corporation reprint series. This product is part of the RAND Corporation reprint series. RAND reprints present previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints have been formally reviewed in accordance with the publisher's editorial policy, and are compliant with RAND's rigorous quality assurance standards for quality and objectivity.
Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.