Asthma Education in Pediatrics: Instituting an Electronic Health Record Alert for Discharge

Inconsistent asthma discharge education in pediatric emergency departments (EDs) contributes to readmissions and increases healthcare costs. Despite existing pathways, a pediatric ED within a large nonprofit health organization showed only 24% provider adherence to asthma discharge rescue plans in 2023. This quality improvement (QI) project, using the Chronic Care Model (CCM), aims to address this gap by implementing an electronic health record (EHR) alert to improve discharge practices. The goal is to enhance provider adherence to discharge orders, increase patient education, and reduce hospital readmission rates. An EHR alert was collaboratively designed with the IT department and embedded into the system. Triggered by specific ICD-10 codes and ED asthma management pathway activation, the alert prompts providers to select appropriate discharge education, thereby improving clinical decision support. A pre- and post-implementation design, using an internal data collection tool, evaluated the alert's impact on provider adherence and 30-day readmission rates. This EHR alert is hypothesized to improve order adherence, increase patient education, and decrease hospital readmissions. A two-tailed Wilcoxon signed-rank test yielded significant results (p = .012), indicating that standardizing asthma rescue plans in the ED leads to a clinically significant reduction in asthma-related hospital readmissions. Integrating this alert, guided by the CCM, standardized processes, improved care quality, and enhanced care transitions by optimizing asthma discharge education.