Wolfson Children’s Hospital’s Community Asthma Partnership Improves Quality of Life and Reduces Hospital Admissions
Asthma is the number one reason children miss school, and the leading cause of hospitalization among children in Northeast Florida. It is estimated that more than 60,000 people live with asthma in the greater Jacksonville area. Many of those are children whose families are unaware that they have the disease. Wolfson Children’s Hospital’s Community Asthma Partnership helps manage and treat asthma in the Jacksonville area by providing the resources and education necessary for children, their families and their physicians to ensure consistent, eﬀective care that changes children’s lives.
The Community Asthma Partnership (CAP) began in 1992 as a cooperative eﬀort among hospitals, the Duval County Health Department, and pediatric and adult pulmonologists and allergists across the region. Wolfson Children’s Hospital became the lead managing and funding organization in 2006, and the program was renamed to the Community Asthma Partnership at Wolfson (CAPW). The goals include improving asthma awareness, education and quality of care, and increasing access to asthma care regardless of insurance status. The program provides asthma education in schools, child care centers and in the community. During the week, respiratory therapists educate students at schools about asthma treatment and management. In addition, Wolfson Children’s Hospital hosts monthly asthma training classes for families who don’t attend the schools that the hospital partners with. Asthma patients and their families can attend the outpatient classes at no cost with a referral from their physician or self-referral, or if they are discharged from the hospital with an asthma diagnosis and require additional education.
The program was expanded in 2009 to educate health professionals treating pediatric asthma patients in the Jacksonville area. Although the CAPW was eﬀectively reaching many students, their families, and school educators about the importance of managing asthma appropriately, challenges remained with consistent physician treatment. The addition of CAPW’s Easy Breathing® program has been particularly helpful in training health care providers on the evidence-based protocols needed to help control asthma among children in the community.
Easy Breathing® is an evidence-based asthma management program designed for primary care oﬃces. It includes physician training and tools to improve recognition of asthma among children, as well as classiﬁcation of asthma severity. The program adheres to the National Asthma Education and Prevention Program (NAEPP) Guidelines of 2007 and current National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC) guidelines. Physicians in the Jacksonville community participate in the Easy Breathing® training provided by Wolfson Children’s Hospital’s trained specialists. They then enroll their pediatric asthma patients in the Easy Breathing® program, which helps simplify the guidelines for primary care doctors to ensure that children with asthma symptoms receive the treatment and medications most appropriate for the severity of their diagnosis.
As a result of the Easy Breathing® program, physicians are consistent, children are treated with the right kind of medicine, emergency room visits are prevented and childrens’ quality of life and health is greatly improved. A recent analysis of the program found that children who are enrolled in the Easy Breathing® program had a decrease in emergency room visits of 58 percent when compared to the previous year of treatment without the program. In addition, when children and their families attend the Saturday CAPW asthma training, 70 percent were not readmitted to the hospital for at least one year following that educational opportunity.
Because of the program’s success, Wolfson Children’s Hospital now proactively identiﬁes patients who may beneﬁt from the program. Children with asthma who are admitted to the hospital two or more times in the same year qualify as “high risk for death” patients. When this happens, patients are ﬂagged, and an asthma case manager follows up with patients and their family to ensure that they are prescribed the appropriate medications, and receive the necessary education, and a home visit may be conducted to look for potential asthmatic triggers. Case managers also assist patients in connecting with a primary care physician, and training and enrolling patients’ existing primary care physicians in the Easy Breathing® program.
Wolfson Children’s Hospital donates $250,000 annually to support its asthma education and treatment eﬀorts, including CAPW, the Easy Breathing® program, and free supplies such as allergy-proof pillow casings and spacers for use with inhalers and incentives.
“Through CAPW’s Easy Breathing program, we have screened nearly 2,000 patients since 2009; of those, nearly 25 percent have been diagnosed with asthma. We have a signiﬁcant percent of patients who were going to the ER on a regular basis, so the program ﬁrst helped us to capture those patients who otherwise would have been missed without the Easy Breathing survey.
-Rosa I. Hidalgo-Laos, MD, Medical Director, SouthJax
Family Health Center, Jacksonville, FL