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Asthma Outcomes Pathway (Text Version)

Slide presentation from the AHRQ 2009 conference.

On September 14, 2009, Lori Palensky made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (3 MB).

Slide 1

Asthma Outcomes Pathway

Lori Palensky
Saint Elizabeth Foundation
Lincoln, NE

Slide 2


  • says...
  • Asthma is a predisposition to chronic inflammation of the lungs in which the airways (bronchi) are reversibly narrowed. Asthma affects 7% of the population, and 300 million worldwide.

Slide 3


  • Devastating chronic disease
  • Public impact has increased over the last two decades
  • Qualifies as a public health epidemic
  • Nebraska-#2

Slide 4


  • CAEI launched in 1998 at Saint Elizabeth Regional Medical Center-
  • Funding-
  • Asthma Coordinator
  • 30 Agencies -

Slide 5

CAEI Management
of Asthma

  • 1. Healthcare Provider Education Pyramid
  • 2. Family Asthma Adventure
  • 3. Pharmacist Intervention
  • 4. Asthma Awareness
  • 5. Asthma Surveillance

Developed to bridge the patient-provider communication gap.

Slide 6


  • Saint Elizabeth Regional Medical Center
  • Pharmaceutical
  • EPA
  • Private and Community Based Organizations

Slide 7


  • Catholic Health Initiative—
  • Mission & Ministry Fund through the
  • Saint Elizabeth Foundation

Slide 8

Asthma Outcomes Pathways

  1. Task Force formed
  2. AHRQ Face-to-Face
  3. Recruit partners-form liaison with ED Connection
  4. Work groups assemble pathway—technical assistance Dr. Redding
  5. Define barriers and embed into pathways process
  6. Determine outcome measures specific to intervention
  7. Finders and connectors trained with referral mechanism
  8. Develop return on investment, and create audit system
  9. Begin documenting
  10. Build system for review and quality assurance

Slide 9


Identify Patients Most at Risk
Census Tract NESW
Socioeconomic Status
No Medical Home

Begin Asthma Action Plan

Slide 10

Intervention Specific-Education & Referral

Barrier Reduction → Environmental Assessment → Outcome

Barrier Reduction → Medical Home → Outcome

Barrier Reduction → Medical Management Review → Outcome

Finalize Asthma Action Plan

Short term—Outputs
Long term—Clinical methods

Slide 11


  • Web-based case management
  • Provides connectivity for Head Start school nurses and ED case managers
  • Utilizes customized care algorithms
  • Prints vouchers and maintains inventory of funds
  • Stores data for outcomes and reporting

Slide 12

Asthma Outcomes Pathways

Image: Logo for Asthma Outcomes Pathways.

Slide 13

Case Managers

  • Outcomes Pathways streamlines their workload using algorithms for protocols and readily available vouchers for barrier reduction
  • These "finders" are familiar and trusted by the target group
  • These "finders" are invested in the target groups and in connections for barrier reduction
  • Penelope connects Head Start, schools and Emergency Departments

Slide 14

How is this improving access?

  • The medical community becomes accountable to each other—' it takes a village approach'
  • Bridges the communication gap
  • Provides an evidence based program
  • A kinder and gentler approach for
  • health care with the indigent.

Slide 15


  • Reduced duplication of services
  • Unites at-risk population to evidence based intervention
  • Identify and overcome barriers to care
  • Reduces exacerbation through asthma management education
  • Reduced number of sick days at school and work
  • Number of symptom free days increase
  • Decrease recurrent visits in Emergency Departments

Slide 16

Asthma Outcomes Pathway Future

  • Continue to add to the number of Outcomes Asthma Pathways
  • Foster and maintain relationships with community partners
  • Once the pediatrics population is saturated develop the second pathway for the elderly population
  • Share and mentor other communities in Nebraska.

Slide 17

Thank You, for your time.

  • For more information:
    • Saint Elizabeth Foundation
    • 6900 'L' Street, Suite 100
    • Lincoln, NE 68510
    • 402.219.7051

Slide 18

Catholic Health Initiatives Saint Elizabeth Foundation

Current as of December 2009
Internet Citation: Asthma Outcomes Pathway (Text Version). December 2009. Agency for Healthcare Research and Quality, Rockville, MD.


The information on this page is archived and provided for reference purposes only.


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