Chest
Clinical Investigations: AsthmaResults of a Program to Improve the Process of Inpatient Care of Adult Asthmatics
Section snippets
MATERIALS AND METHODS
Beth Israel Medical Center (BIMC) is a 960-bed teaching hospital that draws many of its patients from the lower east side of Manhattan, a geographic area and population that has hospital admission and death rates for asthma that are above the national average.3,4 BIMC has approximately 400 adult asthma hospital admissions and 3,000 Emergency Department visits for asthma per year. Eighty percent of hospitalized asthmatics have no private physician and are cared for by 120 medical house officers
RESULTS
From November 1991 through January 1992 (preintervention), there were 78 service admissions that fulfilled eligibility criteria. Seventy-two charts were available for review; these hospital admissions were generated by 61 patients. Forty-three patients (60%) had asthma uncomplicated by other serious illness. From November 1992 through January 1993 (postintervention), there were 78 eligible admissions. The records of 72 hospitals admissions were available for review, generated by 65 patients.
DISCUSSION
This study reports the results of a program to improve the treatment process of adults hospitalized for acute exacerbations of asthma. For 3 years before the program was started, we attempted to improve inpatient treatment patterns using group didactic lectures, teaching rounds, and distribution of National Asthma Education Program guidelines6 to all house staff. The treatment patterns reported in the preintervention patients are the result of vigorous teaching efforts by a few attending
ACKNOWLEDGMENT
The authors thank Thomas Killip, MD, for his careful editing of the manuscript.
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