L+M wins statewide award for asthma program

New London — To reduce the number of adult and child patients showing up at the Emergency Department with asthma symptoms, Lawrence + Memorial Hospital three years ago created the Breathe Well-Respira Bien program, particularly targeting Hispanic and black populations with high rates of asthma.

Due to the success of the program, the hospital on Wednesday received the John D. Thompson Award for Excellence in the Delivery of Healthcare Through the Use of Data from the Connecticut Hospital Association. The award was given at the association's annual meeting in Wallingford.

“The Breathe Well-Respira Bien intervention is empowering people to take control of their asthma,” Jennifer Jackson, chief executive officer of the hospital association, said in an announcement. “The proven results of this project are not only being apparent in the data today, but will impact the future for many of the young people being served.”

The program focused on Hispanics and blacks with asthma after a community health survey showed these populations were most likely to visit the hospital for asthma symptoms four or more times per year, L+M said in information submitted to the hospital association for the award.

Laurel Holmes, director of community partnerships and population health, said Thursday that the program has thus far worked with 60 adults and children with asthma, teaching them about asthma triggers and proper use of asthma medications. It initially focused efforts on families at the Winthrop STEM Elementary Magnet School, where about 25 percent of children are diagnosed with asthma, and has now expanded to C.B. Jennings Elementary School, she said. The program targeted fourth- and fifth-graders.

“We did hear about a lot of kids were missing whole days of school because of asthma, and missing classroom time because they were having trouble breathing and spending time in the nurse’s office,” she said. "Our participating children have really improved on both those fronts."

Of the adults who participated, 16.7 percent had well-controlled asthma at the start of the program. After the intervention, that percentage almost tripled to 47.6 percent, the hospital association said. The measure was based on a questionnaire about symptoms and daily functioning to determine asthma control.

Children in the program also showed strong improvement. At the start, 37 percent had well-controlled asthma. After the intervention, that number went to 74.3 percent.

The program includes the creation of weekly reports to track emergency department utilization for asthma. Based on the results, a community health worker reaches out to each patient, offering education workshops in English and Spanish. In addition to post-emergency department visits, the worker also met with students at their schools, giving them special classes in English and Spanish in how to manage their asthma, Holmes said. A grant from the Frank Loomis Palmer Fund pays for the community health worker. 

“The goal of the program is for people to manage their asthma so they don’t have to come to the emergency room, or be admitted to the hospital,” Holmes said.

One of the key findings, she added, is that many asthma patients were not using medications correctly, relying only on the “rescue” medications when symptoms became severe and not using the maintenance medications routinely.

A new facet of the program is beginning this summer, Holmes added. Ten parents of children with asthma last week completed training to become parent health promoters who will teach other parents about the best ways to control their children’s asthma.

Data provided by the hospital shows a drop in total visits to the hospital by asthma patients from 2013 to 2016, including emergency department visits and hospital admissions. A total of 1,334 patients visited the Emergency Department for asthma in 2013, compared to 1,009 in 2016. In 2013, the hospital admitted 155 people for asthma, compared to 76 in 2016, the data shows. 

By the numbers

Asthma hospital visits at L+M:

2013: 1,503

2014: 1,316

2015: 1,443

2016: 1,113

Includes inpatients, emergency department visits without admission and outpatient observations.

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