Improving allergy office scheduling increases patient follow up and reduces asthma readmission after pediatric asthma hospitalization

Publication date: Available online 28 August 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Melanie A. Ruffner, Sarah E. Henrickson, Marianne Chilutti, Robert Grundmeier, Jonathan M. Spergel, Terri F. Brown-Whitehorn

Abstract

Background

Pediatric asthma is a major contributor to emergency room utilization and hospital readmission rates.

Objective

To develop an allergy department-based intervention to improve follow-up appointment scheduling processes for pediatric asthma patients following discharge for asthma exacerbation.

Methods

This quality improvement (QI) study was conducted in the allergy clinic of an urban, tertiary children's hospital. Children receiving subspecialty allergy care for asthma were included into the intervention group during the intervention period. The QI intervention consisted of three attempts by telephone to reach the family to schedule the follow-up appointment. If this was unsuccessful or if the appointment was not kept then a reminder letter was sent to the family. The primary outcome of interest in this study was the percent of post-discharge follow-up appointments scheduled within 30 days of discharge. Secondary outcomes measured were the percent of allergy appointments attended within 30 days of discharge and the 30-day hospital readmission rate.

Results

Demographics did not differ significantly between the intervention and baseline pre-intervention year. The initial baseline scheduled allergy follow-up visit rate was 48.8±13.3% of patients discharged per month. This increased to an overall rate of 75.7±20.1% patients scheduling allergy follow-up within 30-days of discharge during the intervention year. We additionally observed a significant increase in attended allergy visits 30 days post-discharge from 35.5±15.6% in Year 1 to 53.9±25.5% during the intervention year and a significant decrease in the 30-day readmission rate on the allergy service.

Conclusion

This data suggests that minor changes in allergy practice organization can significantly affect post-hospitalization follow-up rates and decrease asthma readmission rates.

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