A review of an Asthma ED discharge Quality Improvement (QI) pathway within an Irish Hospital

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A review of an Asthma ED discharge Quality Improvement (QI) pathway within an Irish Hospital Introduction: Appropriate emergency department (ED) management of asthma including discharge plan in critical. An audit of asthma patients attending an ED in our tertiary referral centre revealed no patient had a completed asthma bundle and only 7% were referred ro respiratory services on discharge. We indentified a need for asthma patients to receive improved asthma care post ED attendance and created a new asthma pathway to meet this need. Method: The programme accepts patients > 18 years with asthma symptoms who have attended the ED or AMU in Galway University Hospital.. On acceptance into the the pathway all patients recieve an education pack including a peak flow meter and diary. Each patient is reviewed at 2-6 weeks, 3 and 6 month follow up post ED attendance. All participants provided written consent. The study was approved by the Galway University Hospital research ethics commitee. All patients were offered spirometry and FeNO measurement. All clinical data was extracted prospectively. Outcome measures included exacerbation rates, hospital attendance and admission rated/ Results: 35 patients consented for participation and completed 6 month follow up. Median participant age was 33 years, with 47% female. All patients (100%) recieved asthma education and asthma control plans. All current smokers recieved smoking cessation advice. Inclusion in the study resulted in reductions in exacerbation, steriod and antibiotic use and hospital attendances . Conclusion: This Asthma QI pathway has demonstarted how focused interventions can enhance the quality of life for people living with asthma

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