New asthma care pathway to help children breathe easier

MEDICINE HAT – A new Alberta Health Services (AHS) pilot project aims to reduce the need for children with asthma to visit the emergency department or to require hospital care.

Last week, Medicine Hat Regional Hospital implemented a new AHS care pathway, specially developed for these children and their families by a team of experts in the AHS Respiratory Clinical Network. The pathway brings together best evidence and practices for treating childhood asthma to help guide health professionals and educate families and children.

Individuals under the age of 18 who visit the Medicine Hat ED and/or require hospitalization due to asthma will be cared for according to this pathway.

“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 & 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.”

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

The new pathway involves several co-ordinated strategies. They include:

• A treatment plan is available to health providers in emergency departments 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.

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

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than 3.7 million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

• News release

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