AAFA’S BREATHMOBILES: HOW THEY WORK
Board certified allergists and/or nurse practitioners, nurses, respiratory therapists and patient service workers provide services on each Breathmobile® including diagnosis, a physical examination, patient history, pharmacological therapy, free medicine, spirometry, limited skin testing, as well as peak flow meter testing. A validated school based screening process provides an efficient method to help identify children with poorly controlled asthma to be seen on the Breathmobile®. School nurses also help recruit children with asthma. Every six to eight weeks the Breathmobile® returns to the school to provide continuous asthma care.
Each Breathmobile® provides patient and parent education that focuses on the proper use of medicines and the appropriate use of metered dose inhalers, spacing devices and nebulizer treatments. Environmental control measures, such as the rationale for the use of bed coverings, are an important educational component. Educational materials in different languages, along with educational displays and videos help reinforce concepts presented to the patients by the medical team.
Evaluation studies have demonstrated dramatic improvement for patients treated on the Breathmobile®. This includes: fewer emergency room visits, improved pulmonary function, decrease in school absenteeism, and improved quality of life. The data also suggest that the majority have had significant improvement in their status within the first 6 months. An average of only 2 Breathmobile® visits is typically required for patients with mild and moderate asthma to achieve control, whereas patients with severe asthma require an average of 3 visits. The program has demonstrated to be an efficient way to provide care to high risk disadvantaged children.
PEDIATRIC ASTHMA DISEASE MANAGEMENT PROGRAM
The care delivered on all the Breathmobiles® is coordinated at the Pediatric Asthma Disease Management Center at the LAC+USC Medical Center. “The Breathmobile® program is a wonderful example of synergy between health care organizations that are solely committed to the improvement of children’s asthma,” said Craig Jones, MD, founder of the program, and one of the principle researchers. Demographic, clinical, and outcomes information from each of the Breathmobiles® is integrated at this center where care coordinators contact families to facilitate participation in ongoing preventive care.
In 2002 the Pediatric Disease Management Center became the first disease specific care program in the United States to be credentialed by the Joint Commission on Accreditation of Health Care Organizations (JCAHO). A thorough onsite review of the healthcare process, data collection, analysis, and performance improvement process led to the credentialing by JCAHO.
The Breathmobile® has been proven to be an efficient model to provide long term preventive care to children with asthma. Other cities throughout the nation have replicated the program.