Health Care Delivery ResearchLearning from a Distance: Effectiveness of Online Spirometry Training in Improving Asthma Care
Section snippets
Methods
Collaborators at the New York Department of Health identified 28 potentially eligible pediatric practices from their asthma QI consortium in September/October 2007. Eight of these practices did not adequately match other eligible practices. Sixteen of the remaining 20 practices were enrolled (eligible response rate = 80%; Fig. 1). Thus, 8 practice pairs were matched on the following criteria: number of pediatric providers (±1); urban versus suburban/rural location; percent of Medicaid-eligible
Results
Sixteen practices (8 matched pairs) were recruited and enrolled, but one intervention practice dropped out because of competing priorities, leaving 7 matched practice pairs. Most practices (11/14) provided care primarily for Medicaid-insured populations. Most practices were urban, ranged in size from a solo practice to 10-provider practices, and represented a variety of practice types (Table 2). The number of participants in the intervention practices ranged from 1 to 6 providers. Seven of the
Discussion
We successfully delivered a multifaceted spirometry distance-training program from Seattle, Washington, and other faculty locations to seven pediatric practices in New York. The percentage of acceptable quality spirometry sessions performed among intervention practices increased significantly compared with controls. Other findings support the stated program aim: improving primary care management of children with asthma. During the 7-month QI program, intervention practices had a significantly
Conclusions
A multifaceted distance QI training and feedback program resulted in increased spirometry quality and improved assessment of asthma severity levels. Successful participation in QI programs focused on procedures such as spirometry can occur over distance.
Acknowledgments
We gratefully acknowledge the help of Ms. Patricia A. Waniewski RN, MS, for recruitment of both faculty and practice teams; Mr. Jeff Byrne RRT, for leading the coaching webinars; Mr. Carl Zimmer from Biomedical Systems for reporting system support; and Ms. Julie Peterson, Ms. Alexis Coatney, Ms. Alison Long, and Ms. Bonnie Rains for project coordination and support. Funded by the Agency for Healthcare Research and Quality Grant HHSA290200600022, Task Order 2, 2007-2009, and administered by the
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