Nursing & Care


Increasing Provision Rate of Asthma Action Plans in Primary Care: A Quality Improvement Project

Hutchison, Lynne M., DNP, FNP-BC

Asthma is a major health concern in the United States affecting 25 million people. Improved outcomes for patients with asthma have been demonstrated through the use of written asthma action plans (AAP). Health People 2020 has a goal for 37% of all persons with asthma to receive a written plan of care. Data gathered before initiation of this project indicated only 19% of patients with asthma had a written asthma action plan at this large outpatient group practice. The survey indicated that lack of time was a major barrier to initiating AAPs.

Goal statement: Would an education program provided to healthcare providers of various disciplines on a teambased care workflow process change, versus current practice, increase the number of asthma action plans developed for patients?

Utilizing the Chronic Care Model and recommendations from the National Asthma Education and Prevention Program as guides for this project, an education module was developed and presented to all members of healthcare teams in 7 primary care practices. One month after the education program was conducted and the process change implemented, retrospective chart audits (n=704) were performed on patients seen during that time frame with a diagnosis of asthma. All 7 teams showed an increase in the percentage rate of AAPs generated. Three teams showed statistically significant increases in provision rates of AAPs. The provision rate of AAPs for the organization at large showed a statistically significant increase (30%, p=.0005) compared to preintervention rates (19.9%). Benefits to patients were receipt of a written AAP.