A Quality Improvement Study Using Fishbone Analysis and an Electronic Medical Records Intervention to Improve Care for Children With Asthma

Jonathan Gold, David Reyes-Gastelum, Jane Turner, H. Dele Davies

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Despite expert guidelines, gaps persist in quality of care for children with asthma. This study sought to identify barriers and potential interventions to improve compliance to national asthma prevention guidelines at a single academic pediatric primary care clinic. Using the plan-do-check-act (PDCA) quality improvement framework and fishbone analysis, several barriers to consistent asthma processes and possible interventions were identified by a group of key stakeholders. Two interventions were implemented using the electronic medical record (EMR). Physician documentation of asthma quality measures were analyzed before intervention and during 2 subsequent time points over 16 months. Documentation of asthma action plans (core group P <.001, noncore group P =.004) and medication counseling (core group P <.001, noncore group P <.001) improved substantially by the third time point. A systematic approach to quality improvement using PDCA and fishbone analysis in conjunction with embedded EMR tools can improve asthma care in a pediatric primary care setting.

Original languageEnglish (US)
Pages (from-to)70-77
Number of pages8
JournalAmerican Journal of Medical Quality
Volume29
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • PDCA
  • asthma
  • electronic health records
  • fishbone analysis
  • pediatric
  • quality improvement

ASJC Scopus subject areas

  • Health Policy

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