A Practical Model to Transform Childhood Asthma Care - Spirometry Training in the Primary Care Setting
Implementing Evidence-based Quality Improvement Strategies to Improve Asthma Care for Children
Spirometry is a recommended component of asthma diagnosis and treatment in the primary care setting, however, few primary care providers report routine use of spirometry in the provision of care for their asthma patients. Even when spirometry is used to aid in asthma severity classification, primary care providers have a high rate of failing to meet the quality goals for testing established by the American Thoracic Society.
The goal of this study is to evaluate the effectiveness of a virtually delivered quality improvement (QI) program. The program is designed to train primary care providers and their medical staff in the use of spirometry to improve pediatric primary care management for children with asthma.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
A cluster randomized trial with matched practice pairs. All practices receive a spirometer and standard vendor training. Those randomized to the intervention group receive a 7-month QI program, which includes:
- Spirometry Fundamentals™ CD-ROM;
- Case-based, interactive webinars; and
- an Internet-based spirometry quality feedback reporting system.
Studietype
Registrering (Faktiske)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiesteder
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Washington
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Seattle, Washington, Forente stater, 98195
- University of Washington
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-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Internet access on a computer running Windows XP SP2
- Access to a computer with Windows 2000 /Mac OS 10 or higher
Practices must match another enrolled practice on the following parameters.
- Number of providers in practice (same number +/- 1 provider)
- Location - both practices must either be urban or rural
- % of patients eligible for Medicaid (same percentage +/- 15%)
- Practice type (school-based clinic, Federally Qualified Health Center, private practice, hospital- or university-based clinic)
- Geographic distance (minimum of 10 miles away from matched pair practice)
Exclusion Criteria:
- Lack of Internet access on a computer running Windows XP SP2
- Lack of access to a computer with Windows 2000 /Mac OS 10 or higher
- Practices that were unable to be matched to another similar practice
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Helsetjenesteforskning
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Ingen inngripen: Velferdstandard
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Eksperimentell: Intervention
Virtually delivered spirometry quality improvement program
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Sites in the intervention arm receive the virtually delivered QI program. The program includes:
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Spirometry test quality
Tidsramme: Seven months
|
Percentage of acceptable quality spirometry tests as determined by standards set by the American Thoracic Society.
|
Seven months
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Presence of asthma care plan
Tidsramme: Seven months
|
To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which written asthma action plans are completed.
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Seven months
|
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Asthma severity documentation
Tidsramme: Seven months
|
To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which asthma severity is appropriately documented.
|
Seven months
|
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Appropriate prescription of controller therapy
Tidsramme: Seven months
|
To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which appropriate controller therapy is prescribed.
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Seven months
|
|
Frequency of office-based spirometry
Tidsramme: Seven months
|
To test whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which office-based spirometry is used in the management of children with asthma.
|
Seven months
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Rita Mangione-Smith, MD, MPH, University of Washington/Seattle Children's Hospital
- Hovedetterforsker: James W Stout, MD, MPH, University of Washington
Publikasjoner og nyttige lenker
Hjelpsomme linker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 32583-E/B
- HHSA290200600022, Task order 2 (Annet stipend/finansieringsnummer: Agency for Healthcare Research and Quality)
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