Implementing the breathe easy protocol: a quality improvement project to standardize asthma management in a rural primary care setting

Abstract

Background: Asthma is one of the most common chronic lung diseases in the United States and is characterized by cough, wheezing, and breathlessness. Asthma management aims to reduce symptoms to provide a higher quality of life with better symptom management. Utilizing a written asthma action plan (AAP) is one method to standardize asthma management and give patients a written plan to manage their symptoms best using their prescribed asthma medications. This project aims to implement the Breathe Easy Protocol in rural primary care. Methods: For this quality improvement project, the Knowledge-to-Action Model will be utilized. The Breathe Easy Protocol uses an asthma control test (ACT) scoring tool and an electronic asthma action plan within the EHR. Throughout the implementation of the Breathe Easy Protocol, evaluations will be conducted to evaluate the clinic staff's perception and usability of the protocol. Chart audits will also be completed six weeks, ten weeks, and fourteen weeks after implementation to evaluate the percentage of asthma patients who have a completed asthma control test (ACT) and an electronically completed asthma action plan within the EHR with an end goal of 80% of patients with an asthma action plan by May 2023. Results: After the 8-week implementation period, in a post-implementation survey, clinic staff reported they were confident identifying which patients were to be screened with the ACT tool. Providers reported feeling confident in their ability to assess, manage and treat pediatric asthma patients and were satisfied with the new management tool. Conclusion: Implementing The Breathe Easy Protocol was a significant step toward a standardized approach to managing asthma that aligns with clinical practice guidelines in this rural community clinic. More work needs to be done to evaluate the effectiveness of the new workflow by evaluating patient charts for completeness of the ACT scoring tool along with an updated asthma action plan. Further work with the Breathe Easy Protocol could also center around implementation in an inpatient setting.