Weiss KB, Mendoza G, Schall M, Berwick DM, Roessner J
Boston, Massachusetts, USA: Institute for Healthcare Improvement; 1997

**NOTE: This Breakthrough Series Guide was published in 1997 and has NOT been updated. Please be advised that much of the clinical content may be out of date.**        Institute for Healthcare Improvement’s Breakthrough Series Guide to improving asthma care in children and adults. This Guide includes topics such as: Building capacity for routine assessment of patient outcomes; Reducing unintended variations in care; Streamlining the process of care; Building information systems capacity.

Porter SC, Forbes P, Feldman HA, Goldmann DA. Impact of patient-centered decision support on quality of asthma care in the emergency department. Pediatrics. 2006 Jan;117(1):e33-42.

This article studies communication barriers between parents of children with asthma and clinical emergency department (ED) providers and the related underrecognition of chronicity and severity impede improvements in disease management. The asthma kiosk, a novel patient-driven decision support tool, provides ED clinicians with tailored recommendations for guideline-based treatment.

Evans R 3rd, Gergen PJ, Mitchell H, et al. A randomized clinical trial to reduce asthma morbidity among inner-city children: Results of the National Cooperative Inner-City Asthma Study. Journal of Pediatrics. 1999;135(3):332-338.

This article describes a study which found improved health outcomes in children served by an asthma counselor. This intervention differs from others in that the counselors were Masters of Social Work trained.

Butz AM, Malveaux FJ, Eggleston P et al. Use of community health workers with inner-city children who have asthma. Clinical Pediatrics. 1994;33(3):135-141.

This article describes a home-visiting program which trained lay members of the community to do asthma outreach.

Wissow LS, Warshow M, Box J, Baker D. Case management and quality assurance to improve care of inner-city children with asthma. American Journal of Diseases of Children. 1988;142(7):748-752.

This article describes a before-after study which shows promise for interventions using case management and quality assurance technique in inner-city children with asthma.

Mayo PH, Richman J, Harris HW. Results of a program to reduce admissions for adult asthma. Annals of Internal Medicine. 1990;112(11):864-871.

This article describes a randomized trial of an intensive education program for adults which reduced readmissions.

Lozano P, Lieu TA. Asthma in managed care. Pediatric Annals. 1999;28(1):74-80.

This article displays that asthma programs in managed care use many elements of the Chronic Care Model.

Heinrich P, Homer CJ. Improving the care of children with asthma in pediatric practice: The HIPPO project. Helping Improve Pediatric Practice Outcomes. Pediatric Annals. 1999;28(1):64-72.

This article describes the HIPPO project which demonstrates the use of quality improvement principles in improving asthma care in a primary care pediatric clinic.

Greineder DK, Loane KC, Parks P. A randomized controlled trial of a pediatric asthma outreach program. Journal of Allergy and Clinical Immunology. Mar 1999;103(3 Pt 1):436-440.

This article describes an asthma control trial which showed case management decreased resource use in children with asthma.

Zorc JJ, Scarfone RJ, Li Y, et al. Scheduled follow-up after a pediatric emergency department visit for asthma: A randomized trial. Pediatrics. 2003;111(3):495-502.

This article describes a randomized trial to enhance follow-up after emergency department visits which found many barriers to follow-up. The article found that follow-up was enhanced for children for whom an appointment was made.