Impact of a standardized emergency department asthma care pathway on health services utilization
Abstract Background An evidence-based standardized ED asthma care pathway (EDACP) was developed and implemented in Ontario, Canada. Objective To determine the impact of EDACP implementation and access to ED asthma management resources and specialists on return ED visits. Methods All 173 Ontario hosp...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
|
| Series: | Allergy, Asthma & Clinical Immunology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13223-025-00973-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849335659368546304 |
|---|---|
| author | Chanel Kwok Katherine Lajkosz Carole Madeley Mona Jabbour Teresa To M. Diane Lougheed |
| author_facet | Chanel Kwok Katherine Lajkosz Carole Madeley Mona Jabbour Teresa To M. Diane Lougheed |
| author_sort | Chanel Kwok |
| collection | DOAJ |
| description | Abstract Background An evidence-based standardized ED asthma care pathway (EDACP) was developed and implemented in Ontario, Canada. Objective To determine the impact of EDACP implementation and access to ED asthma management resources and specialists on return ED visits. Methods All 173 Ontario hospitals were surveyed regarding their access to community and ED asthma specialists and ED asthma management resources, including EDACP implementation date and status as of August 2017. Survey data were linked to provincial health administrative data to quantify acute health services utilization. A Poisson regression interrupted time series analysis was conducted. Results Of the 123 hospitals responding to the survey, 44 (35.8%) had approved the EDACP. Data were analyzed for the 5 years preceding (30,028 asthma visits) and 17 months following (7,916 asthma visits) implementation, with a 3-month implementation black-out period. After controlling for auto-regressive factors, EDACP implementation was associated with a 2% reduction in the absolute rate of return ED visits within 72 h (p = 0.0124), and within 7 days (p = 0.0295) at teaching hospitals. The same effect was not seen at community hospitals. Peak expiratory flow testing (available at 77% of sites) and spirometry (available at 45% of sites) were associated with 34% (p = 0.0071) and 23% (p = 0.028) reductions in the odds of return ED visits within 72 h, respectively. Conclusion The positive results from this large-scale effort to implement an evidence-based knowledge translation initiative in diverse settings, suggests there is merit in continuing to invest time and resources to overcome barriers to adoption and implementation of this EDACP. |
| format | Article |
| id | doaj-art-387ff4f75c4745aa9aaa2cd9ff4a73eb |
| institution | Kabale University |
| issn | 1710-1492 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj-art-387ff4f75c4745aa9aaa2cd9ff4a73eb2025-08-20T03:45:11ZengBMCAllergy, Asthma & Clinical Immunology1710-14922025-06-012111910.1186/s13223-025-00973-4Impact of a standardized emergency department asthma care pathway on health services utilizationChanel Kwok0Katherine Lajkosz1Carole Madeley2Mona Jabbour3Teresa To4M. Diane Lougheed5Department of Medicine, University of OttawaInstitute for Clinical Evaluative SciencesThe Lung Association- OntarioDepartments of Pediatrics and Emergency Medicine, University of OttawaInstitute for Clinical Evaluative SciencesInstitute for Clinical Evaluative SciencesAbstract Background An evidence-based standardized ED asthma care pathway (EDACP) was developed and implemented in Ontario, Canada. Objective To determine the impact of EDACP implementation and access to ED asthma management resources and specialists on return ED visits. Methods All 173 Ontario hospitals were surveyed regarding their access to community and ED asthma specialists and ED asthma management resources, including EDACP implementation date and status as of August 2017. Survey data were linked to provincial health administrative data to quantify acute health services utilization. A Poisson regression interrupted time series analysis was conducted. Results Of the 123 hospitals responding to the survey, 44 (35.8%) had approved the EDACP. Data were analyzed for the 5 years preceding (30,028 asthma visits) and 17 months following (7,916 asthma visits) implementation, with a 3-month implementation black-out period. After controlling for auto-regressive factors, EDACP implementation was associated with a 2% reduction in the absolute rate of return ED visits within 72 h (p = 0.0124), and within 7 days (p = 0.0295) at teaching hospitals. The same effect was not seen at community hospitals. Peak expiratory flow testing (available at 77% of sites) and spirometry (available at 45% of sites) were associated with 34% (p = 0.0071) and 23% (p = 0.028) reductions in the odds of return ED visits within 72 h, respectively. Conclusion The positive results from this large-scale effort to implement an evidence-based knowledge translation initiative in diverse settings, suggests there is merit in continuing to invest time and resources to overcome barriers to adoption and implementation of this EDACP.https://doi.org/10.1186/s13223-025-00973-4AsthmaEmergency departmentCare pathwayHealth services use |
| spellingShingle | Chanel Kwok Katherine Lajkosz Carole Madeley Mona Jabbour Teresa To M. Diane Lougheed Impact of a standardized emergency department asthma care pathway on health services utilization Allergy, Asthma & Clinical Immunology Asthma Emergency department Care pathway Health services use |
| title | Impact of a standardized emergency department asthma care pathway on health services utilization |
| title_full | Impact of a standardized emergency department asthma care pathway on health services utilization |
| title_fullStr | Impact of a standardized emergency department asthma care pathway on health services utilization |
| title_full_unstemmed | Impact of a standardized emergency department asthma care pathway on health services utilization |
| title_short | Impact of a standardized emergency department asthma care pathway on health services utilization |
| title_sort | impact of a standardized emergency department asthma care pathway on health services utilization |
| topic | Asthma Emergency department Care pathway Health services use |
| url | https://doi.org/10.1186/s13223-025-00973-4 |
| work_keys_str_mv | AT chanelkwok impactofastandardizedemergencydepartmentasthmacarepathwayonhealthservicesutilization AT katherinelajkosz impactofastandardizedemergencydepartmentasthmacarepathwayonhealthservicesutilization AT carolemadeley impactofastandardizedemergencydepartmentasthmacarepathwayonhealthservicesutilization AT monajabbour impactofastandardizedemergencydepartmentasthmacarepathwayonhealthservicesutilization AT teresato impactofastandardizedemergencydepartmentasthmacarepathwayonhealthservicesutilization AT mdianelougheed impactofastandardizedemergencydepartmentasthmacarepathwayonhealthservicesutilization |