A Quality Improvement Bundle Including Pay for Performance for the Standardization of Order Set Use in Moderate Asthma.

Creator(s)

Gregory P. Conners, Children's Mercy Hospital
Milton Fowler, Children's Mercy HospitalFollow
Brian R. Lee, Children's Mercy HospitalFollow
Lisa L. Schroeder, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

10-2018

Identifier

DOI: 10.1097/PEC.0000000000001627

Abstract

OBJECTIVE: In order to standardize use of our hospital's computerized asthma order set, which was developed based on an asthma clinical practice guideline, for moderately ill children presenting for care of asthma, we developed a quality improvement bundle, including a time-limited pay-for-performance component, for pediatric emergency department and pediatric urgent care faculty members.

METHODS: Following baseline measurement, we used a run-in period for education, feedback, and improvement of the asthma order set. Then, faculty members earned 0.1% of salary during each of 10 successive months (evaluation period) in which the asthma order set was used in managing 90% or more of eligible patients.

RESULTS: At baseline, the asthma order set was used in managing 60.5% of eligible patients. Order set use rose sharply during the run-in period. During the 10-month evaluation period, use of the asthma order set was significantly above baseline, with a mean of 91.6%; faculty earned pay-for-performance bonuses during 8 of 10 possible months. Following completion of the evaluation period, asthma order set use remained high.

CONCLUSIONS: A quality improvement bundle, including a time-limited pay-for-performance component, was associated with a sustained increase in the use of a computerized asthma order set for managing moderately ill asthmatic children.

Journal Title

Pediatric emergency care

Volume

34

Issue

10

First Page

740

Last Page

742

MeSH Keywords

Ambulatory Care Facilities; Anti-Asthmatic Agents; Asthma; Child; Drug Therapy, Computer-Assisted; Emergency Service, Hospital; Humans; Quality Improvement; Reimbursement, Incentive

Keywords

Ambulatory Care Facilities; Anti-Asthmatic Agents; Asthma; Computer-Assisted Drug Therapy; Emergency Service; Quality Improvement

Recommended Citation

Conners GP, Fowler MA Jr, Lee BR, Schroeder LL. A Quality Improvement Bundle Including Pay for Performance for the Standardization of Order Set Use in Moderate Asthma. Pediatr Emerg Care. 2018;34(10):740-742. doi:10.1097/PEC.0000000000001627