Inpatient Quality Improvement Interventions for Asthma: A Meta-analysis

Abstract

We did not identify any inpatient strategies impacting health care reutilization within 30 days of index hospitalization. Multimodal interventions demonstrated impact over the longer interval.

Adverse events in Malaysia: Associations with nurse's ethnicity and experience, hospital size, accreditation, and teaching status

“…The delivery of high‐quality and safe healthcare is a challenge facing leaders, decision makers, and healthcare providers. Several interventions and initiatives have been performed for optimizing health and care delivery for populations . However, there remain substantial numbers of adverse events which continue to jeopardize health and healthcare.…”

Clinical Progress Note: Care of Children Hospitalized for Acute Asthma Exacerbation

“…12,13 A meta-analysis of asthma-related quality improvement interventions also did not find an association between pathway implementation alone and decreased readmissions or ED revisits. 15 The lack of improvement in these metrics may have been caused by the tendency for pathways to focus on the acute asthma management and lack of focus on chronic asthma severity. Asthma admissions are an opportunity for full evaluation of disease severity, allergen exposures, and education on medication and spacer technique.…”

Inpatient Asthma Care and Future Morbidity: A Role for Quality Improvement

“…2 The best predictor of future severe asthma exacerbations is a recent asthma exacerbation. 3,4 In "Inpatient Quality Improvement Interventions for Asthma: A Metaanalysis" published this month in Pediatrics, Parikh et al 5 examine the impact of quality improvement (QI) initiatives conducted during inpatient asthma hospitalization on future (postdischarge) asthma morbidity. After reviewing an array of inpatient asthma interventions, they used metaanalysis to conclude that inpatient QI efforts have limited impact on postdischarge asthma outcomes.…”

“…We applaud Parikh et al 5 for conducting this ambitious analysis, especially given the wide range of interventions, methodologies, measured outcomes, and disparate care settings wherein asthma inpatient QI was conducted. We also congratulate them for evaluating whether inpatient QI work alone has short-or long-term effects on future asthma morbidity (ie, asthma-related emergency department [ED] revisits or readmissions).…”

“…The resulting nonhomogeneity of the studies makes Parikh's et al 5 metaanalysis of overall inpatient asthma QI efficacy inconclusive. However, their article does reveal several important issues.…”