Children, parents can breathe easier

Pediatric asthma care pathway piloted at Medicine Hat hospital

Story by Jennifer de Vries; Photo by Paul Rotzinger

Julie Noble is now breathing easier – and so are her parents, Curtis and Jennifer.

The Medicine Hat girl is only four years old but, over her lifetime, she has made frequent visits to the Medicine Hat Regional Hospital emergency department (ED) when her asthma worsened.

Now a new Alberta Health Services (AHS) pilot project aims to prevent young asthmatics like Julie from needing emergency care or hospitalization.

That’s welcome news for the Noble family.

“Julie has asthma attacks all the time. When she gets sick, she’s susceptible to pneumonia and other types of viruses,” says Curtis.

“I think it’s very important that the AHS Respiratory Clinical Network is taking these steps. Julie’s condition can deteriorate rapidly. Getting her in the door and assessed right away, and getting her the proper attention she needs, help us circumvent problems that might make her sickness a lot worse.”

Childhood asthma results in almost 8,000 ED visits and 650 hospitalizations every year in Alberta.

“The less time a child has to spend in the emergency department or in a hospital is always easier on children and their families. A plan based on best practice helps us work towards that,” says Dr. David W. Johnson, Asthma Working Group Co-Chair, Section of Pediatric Emergency Medicine, and Professor, Departments of Pediatrics and Pharmacology and Physiology, University of Calgary, Faculty of Medicine.

“This pathway is building upon something similar that has been used successfully in Calgary and, with the lessons learned from this pilot, we hope to share this pathway across Alberta to help children receive the best asthma care possible, no matter where they are.”

The new pathway, developed by the Respiratory Clinical Network, involves several co-ordinated strategies. They include:

• A treatment plan is available to health providers in EDs and inpatient units, so patients can start treatment sooner, and that treatment is based on what has been proven to be most effective.
• Following an ED visit or hospital stay, the child’s family physician is informed about what happened, what treatment was received, what follow-up care is required, and what instructions for managing the condition were passed along to the family.
• Health professionals across the province have access to online learning tools that share best practices for treating childhood asthma.
• Educational materials are shared with families so they can better assist with self-management of this chronic condition. These materials include information on when and how to use inhalers, and where timely help is available if the asthma worsens but doesn’t require emergency care.

 

VIDEO: Breathe Easier

“The goal with better management of childhood asthma is to help children increase their physical activity, decrease the presence of other related health concerns and decrease missed time from work and school,” says Johnson.

Asthma is a chronic inflammatory disease of the airways that can cause any or all of the following symptoms: shortness of breath, tightness in the chest, coughing and or wheezing. It’s the most common chronic disease among children, with one in seven children being diagnosed with asthma.

Symptoms families should look for when deciding to take their child to an emergency department for asthma include:

• Reliever medicine does not seem to be helping the child breathe better. 
• Breathing hard and fast. 
• Can’t walk or talk well, or it’s difficult to lie down and sleep. 
• Lips or nails are turning a blue colour.

The Respiratory Clinical Network is a part of AHS’ Strategic Clinical Network (SCN) initiative to reshape health care in different areas of health that will enhance the patient journey, improve outcomes and standardize care delivery across the province. Each network is comprised of health care professionals, researchers, community leaders, patients and policy-makers.

The childhood asthma pathway is one tangible example of this work. SCNs are also working to improve and standardize care delivery in other AHS priority areas: addiction and mental health; cancer care; seniors health; obesity, diabetes and nutrition; cardiovascular health and stroke; and bone and joint health.

To learn more about Strategic Clinical networks visit: http://www.albertahealthservices.ca/6047.asp