The University of Alabama Birmingham School of Medicine (UAB)

A Quality Improvement Initiative to Increase Asthma Screening Among Children and Adolescents with Sickle Cell Disease Post Hospitalization for Acute Chest Syndrome

Project Lead: Brandi M. Pernell

Project AIMs: Increase the appointment show rate for children and adolescents with sickle cell disease (SCD) scheduled for outpatient follow-up following a recent admission for acute chest syndrome (ACS) from 73% to 85% within 1 year. 

Narrative Description: 

Our overall average ACS follow up show rate (77%) increased by 4% compared to the prior year’s baseline. This percentage fell 7 percentage points shy of our target of 85%. We achieved an 85% or greater show rate for 5 out of the 14 months of the project period. We plan to do a deeper dive into these 5 months for discovery of specific actions and processes that enabled us to achieve a higher show rate during those particular months.  

To summarize, the intervention tested in the project has moved us in the right direction towards the achievement of an 85% follow up appointment show rate for ACS encounters. It is critically important to continue this work beyond this award period. We will continue to test small changes and work collaboratively and with our patients to improve the processes surrounding ACS follow up. Perhaps in the future, assignment of QI coaches to the individual awardees could further improve our projects’ design, implementation, analysis and dissemination. Thank you for your funding support for this QI project.  

Diagnostic quality problem type, failure, or category (symptoms, observed problems, gaps in performance) addressed by the intervention

  • Patient delayed or unable to access to care
  • Information gathering
  • Information integration
  • Information interpretation
  • Establishing an explanation (diagnosis)

Root causes/causative factors addressed by the intervention

  • Patient-clinician interaction (includes patient and family engagement)
  • Workflow (includes testing, follow-up, and referrals)
  • Physical environmental or work system factors
  • Health information sharing and accessibility via health IT
  • Knowledge gaps/inexperience

Setting of the diagnostic quality improvement intervention

  • Ambulatory medical care setting (e.g., clinic, office, urgent care)