ECHO-Chicago: Complex Pediatric Asthma
The objective of this QI project is to improve the frequency and consistency of asthma control assessment during patient visits (regardless of visit reason) by increasing completion and documentation of any validated asthma control tests for the primary care providers. Specifically, we seek to increase asthma assessment during well child visits, asthma-related visits, sick visits, and follow-up visits for other reasons. Achieving control in asthma is a primary goal of pediatric care, and assessing the degree of control is a principal step in management.
There are several tools to evaluate asthma control in the clinical setting. The Asthma Control Test (ACT) and the Childhood Asthma Control Test (C-ACT) are validated tools to identify patients with poorly controlled asthma, and the ACT has been shown to reliably reflect asthma control over time. The ACT is designed for patients 12 years or older, whereas the C-ACT is appropriate for children aged 4–11 years. A score less than 20 on either tool indicates poorly controlled asthma with a sensitivity of 71% and specificity of 71% (ACT) or a sensitivity of 68% and specificity of 74% (C-ACT), as compared with forced expiratory volume in 1 second (FEV1) on spirometry, “the gold standard.” However, spirometry may not be available for every patient due to lack of accessibility in clinic and developmental requirements for patient participation in testing. Thus, other measures of asthma control are especially necessary as they are reliable, valid, easy to administer, and do not require FEV1 values. While the ACT/c-ACT are commonly used validated tools to measure asthma control, any other age-appropriate validated measure can be used.
- Increase participating primary care physician's completion and documentation of the validated forms by 20% over baseline at any visit type for patients 4-18 years of age with asthma by completion of 3 months of ECHO-Chicago Complex Pediatric Asthma series participation.
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QIPI Project Physician Lead
Professor of Pediatrics Chief, Section of Academic Pediatrics
Chief, Section of Pediatric Infectious Diseases
Vice Chair, Clinical Services
University of Chicago Medicine
QI Project Owner
Director of Operations
As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine asks everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. This includes any entity producing, marketing, re-selling, or distributing health care goods or services consumed by or used on patients. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months, including financial relationships of a spouse or life partner that could create a conflict of interest. Mechanisms are in place to identify and resolve any potential conflict of interest prior to the start of the activity.
Additionally, The University of Chicago Pritzker School of Medicine requires authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
The University of Chicago Pritzker School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The University of Chicago Pritzker School of Medicine designates this PI CME activity for a maximum of 20 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Sustained QI Cycles: Physicians are required to complete not less than 2 intervention cycles and not less than 3 data collection points:
1st QI cycle
Baseline data collection, analysis/review, identify underlying cause(s)
Intervention(s) to address underlying cause(s)
Post-intervention data collection, analysis/review, identify remaining underlying cause(s)
Post-intervention data collection, analysis/review, identify underlying cause(s) (same as above)
Adjustment(s) / second intervention(s) to address underlying cause(s)
Post-adjustment data collection, analysis/review, identify remaining underlying cause(s)
Attestation forms must be submitted by November 30th in order for us to report credit to your ABMS specialty board and have your credit count for that year.