Pediatric Resident University of North Carolina at Chapel Hill School of Medicine Clemmons, North Carolina, United States
Background: Asthma is one the leading chronic illnesses of childhood and increasingly impacts minorities and lower-income communities. Housing quality is an important aspect of the severity of asthma. Racial and ethnic minorities and low-income families are more likely to reside in substandard housing and live in areas of the community with allergens, mold, and air pollution. We implemented this QI project to improve the reach of a CATCH-grant funded project by increasing the number of referrals to a community resource, Greensboro Housing Coalition (GHC), in both the clinic and inpatient setting. GHC serves to identify and remediate triggers of asthma within the home through cleaning kits, education, and legal involvement, if needed. We target children aged 2-18 with a diagnosis of asthma living in specific zip codes within our community that are most impacted by inequitable housing conditions. Objective: Our aim is to increase the current rate of referrals from the healthcare setting to GHC from 0 per month to 5 per month over a 1-year period. We plan to do so through implementation and optimization of a referral process with participation from key stakeholders, including providers, social workers, GHC, and families. Design/Methods: - We have submitted our proposal to institutional IRB, which deemed our study does not constitute human subjects research. - We used the IHI Model for Improvement to achieve our aim. Using tools such as process mapping, we have designed and implemented several interventions. These interventions include: Creation of a screening pathway to identify patients for referral for both inpatient and outpatient settings, educational material for families in the program, and a standardized template and method for sending referrals. These interventions were tested and optimized in a stepwise fashion using Plan-Do-See-Act cycles. - We will utilize focus groups of families who declined and accepted the referral to assess how best to increase referrals from the patient perspective. - We plan to submit final data on our measures through 3/15/24.
