Pediatric Asthma Treatment Center

The Pediatric Asthma Treatment Center (Peds ATC) was developed from 1997 to December 1999 under the leadership of the pediatric Program Management Group (PMG) with Stephen Guertin, M.D. and Autumn Clos, M.D. as the program champions.

Performance Improvement Programs: Bronchiolitis Head Trauma

The program focuses on frequent respiratory assessment (severity index) and is based on nationally recognized pograms¹ and guided by the latest Evidence Based Medicine for the treatment of pediatric asthma.

Program Milestones

• In 2000, Family Practice and Pediatric Departments and their respective Executive Committees approved moving the ATC from Pilot to the General Admission Phase.
• In January 2001, Pediatric ATC received the "Standard of Care" recognition from all of Sparrow Hospital's governing medical bodies. From this point forward, all asthma patients from ages 18 months to 18 years of age are automatically enrolled into the ATC.
• May 2002, the ATC program was recognized internationally at the American Thoracic Society (ATS) 98th Annual International Conference in Atlanta, Georgia. Sparrow Hospital was represented at the ATS by: Autumn Clos, M.D., Mark Wehner, PMP, RRT, from the Pediatric Program Management Group and Tammara Vannerson, RRT, from the Department of Respiratory Therapy.
• December 2002, Dale Boukma presented the ATC at the Institute of Health Care Improvement 14th Annual Forum on Quality Improvement in Healthcare.
• February 2003, combined billing and assessment records to assist in streamlining the process.
• May 2003, a Certified Asthma Educator was added to provide inpatient asthma education.

Program Overview

The overall philosophy of the ATC is: "From the moment a patient hits our door, he (she) should be getting better".

The treatment of a pediatric asthma patient starts with aggressive care at the point of presentation (Emergency Department or direct admit from a physician's office). All patients receive a "pre-phase", which is agressive rescue treatment within the first 60 minutes of presentation. A thorough respiratory assessment follows the pre-phase to determine if the patient meets discharge criteria.

For those patients who are admitted, the program is designed to match treatment with severity of illness. This is accomplished based on two elements: physical assessment and patient history. These findings allow the patient to be placed into one of three phases: severe, moderate or mild. The ATC phases are time limited and respiratory assessment driven based on a 13 point assessment adminstrated by a Respiratory Therapist (RT). The assessment tool is used to evaluate and move the patient within the program.

Program Performance

• During the 2003 asthma season, the pediatric ATC had an average reduction in LOS of .70 days per year compared to pre-ATC LOS.
• From 2000-2003 the Pediatric ATC had an average LOS reduction of 0.73 days compared to pre-ATC LOS.
• In 2003 Pediatric ATC cared for 224 patients.
• From 2000-2003 there was a total of 760 patients cared for in the program.

Year

Patients

LOS
(Length of Stay)

Pre-Program LOS

LOS Difference

2000

157

1.73

2.5

0.77

2001

193

1.78

2.5

0.72

2002

186

1.77

2.5

0.73

2003

224

1.8

2.5

0.70

Totals

760

1.77

2.5

0.73

¹ Rainbow Babies & Children's Hospital, Cleveland, Ohio; Mayo Clinic, Rochester Minnesota; Cook County Hospital, Cook County, Illinois