Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

OBJECTIVE: To assess gaps in emergency department (ED) asthma management at Florida hospitals.

DESIGN: Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement.

SETTING: Emergency departments at 10 large hospitals in the state of Florida.

PARTICIPANTS: Clinical care providers and health administrators from participating hospitals.

MAIN OUTCOME MEASURES: Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts.

RESULTS: Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up.

CONCLUSIONS: Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.