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Assessing quality of asthma care in your practice-- The Asthma APGAR Barbara P. Yawn, MD, MSc Director of Research Olmsted Medical Center Rochester, MN.

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Presentation on theme: "Assessing quality of asthma care in your practice-- The Asthma APGAR Barbara P. Yawn, MD, MSc Director of Research Olmsted Medical Center Rochester, MN."— Presentation transcript:

1 Assessing quality of asthma care in your practice-- The Asthma APGAR Barbara P. Yawn, MD, MSc Director of Research Olmsted Medical Center Rochester, MN USA February 20, 2004 Melbourne, Australia

2 Assumption: Quality Result

3 Objectives: Identify quality related outcomes Suggest quality indicators Develop process to assess indicators Use indicators to modify practice

4 Quality should focus on: Outcomes that matter to patients Outcomes that matter to families Outcomes that matter to clinicians Outcomes that matter to quality monitors In that order

5 ASTHMA APGAR A=Activities P=Persistence G=triGGers A=Asthma Medications R=Response to Therapy

6 APGAR Results A=Activities –25% % of patients with documented activity limits

7 APGAR Results P=Persistence –Day time symptoms 67% % of patients with frequency of daytime symptoms documented

8 APGAR Results P=Persistence –Night time symptoms 15% % of patients with frequency of night time symptoms documented

9 The severity score addresses the baseline symptom assessment: Does not address the asthma that is being treated nor does it consider attacks

10 APGAR Results G=triGGers –Are them mentioned or treated 34% % of patients with documented triggers

11 APGAR Results A=Asthma medications –Prescribed medications 75% ? Percent that are really taking them that way % of patients with prescribed medications documented and then actual medications taken documented

12 APGAR Results R=Response to therapy –Did they get better or worse 50% % of patients with the response to therapy documented

13 GAPS? Your impressions of the data ? What is currently working well? Why is it working well? What would you like to improve? Systems that you want to change?

14 Solutions A patient asthma APGAR Ask the nurse to give patient the APGAR to complete Develop patient expectations so that they give you their APGAR Use as a control score


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