AKRON, Ohio -  ­ ­ Akron Children’s Hospital has seen a significant decrease in the number of asthma-related ER visits and hospitalizations over the past two years thanks to a hospital initiative that addresses asthma as a high-priority healthcare need.

About 1 in 10 American children suffer from asthma, making it the leading chronic disease in childhood and the chief cause of missed school days. But with treatment, coordination of care and education, most children with asthma can keep their symptoms under control and avoid unplanned hospital visits.

Community health assessments in 2013 and 2016 identified asthma as a significant health need for children in Medina, Portage, Stark, Summit, Wayne, Mahoning, Trumbull, Columbiana and Richland counties.

To address this need, Akron Children’s created a system-wide registry of asthma patients in 2014 and is tracking outcomes.

As a result, Akron Children’s has seen a 15 percent decrease in the number in asthma patients making ER visits and a 30 percent decrease in asthma-related hospitalizations. On an annual basis, these results will save more than $3 million in health care expenditures.  

“This means a lot more kids will be able to stay in school and continue to learn, sleep through the night, and run and play like their friends without asthma,” said P. Cooper White, MD, a pediatrician and medical staff president at Akron Children’s. “Our focus on this area as a hospital has paid off and we are now seeing the results. But we still have more work to do in reaching our goals.”

Easy Breathing

A key component in reducing asthma-related ER visits and hospitalizations is Easy Breathing, an evidence-based asthma management program that is standardizing the diagnosis and treatment of the disease in Akron Children’s 27 primary care offices throughout Northeast Ohio.

“The Easy Breathing program includes training and tools that can aid providers in diagnosing asthma, determining its severity, assessing how well it’s controlled, prescribing appropriate therapies and developing a written asthma treatment plan,” said David Karas, MD, a pediatrician at the Akron Children’s Hospital Pediatrics office in Wadsworth who has been leading the implementation of the program at Akron Children’s.

Easy Breathing is designed to improve identification of previously unidentified cases of asthma. So, as part of the program, all patients of Akron Children’s pediatric primary care practices receive an asthma screening survey, not just those previously identified as having asthma.

“Since 2013, we have been able to identify 1,500 undiagnosed cases of asthma,” said Dr. Karas. “Of these undiagnosed cases, 36 percent have persistent asthma and nearly all of them have been prescribed a daily anti-inflammatory medication.”

The program spells out the appropriate intervals for follow-up based on asthma severity, as well as when a referral to a specialist is needed.

“The Easy Breathing program really brings all the pieces together,” said Dr. White. “It’s a great example of 21st century medicine. It has elements of quality improvement, population health, and effective use of guidelines – and it helps children lead healthier lives.”

In 2017, Akron Children’s will expand efforts to make home visits to asthma patients to assess environmental causes that can worsen asthma, such as mold, pet dander, dust mites, pollen and second-hand cigarette smoke.