Romelia Rodriguez Walters, B.S., A.E.-C., Asthma Allies,
discusses the Home Visit Asthma Management Program
Located in Albuquerque, Rio Rancho, and Santa Fe, New Mexico, the Asthma Allies' Home Visit Asthma Management Program (H-VAMP) educated newly diagnosed patients with asthma on asthma self-management and utilized in-home interventions to decrease their exposure to asthma triggers. This approach, conducted over several home visits with additional follow-up calls, allowed greater time for patient education and for identifying and addressing environmental conditions in the home that affect asthma.
Romelia Rodriquez Walters (left) in discussion with a colleague during a NACI meeting in Baltimore, MD.
Ongoing assessment of patients' progress and program impact included spirometry testing, exhaled nitric oxide monitoring, Asthma Control Test™, and knowledge and quality of life indicators. H-VAMP also provided patients with a symptom journal, holding chamber, peak flow meter, trigger remediation kit, nebulizer, and other asthma self-management tools.
Following the second or third home visit, H-VAMP referred patients back to their physicians for follow-up care. If patients were not currently under the care of a physician, H-VAMP referred them to collaborating specialists.
Utilize certified asthma educators (AE-Cs) to provide in-home asthma education to newly diagnosed asthma patients.
Challenges & Solutions
Challenge: Availability of AE-Cs. Asthma Allies expanded the number of certified asthma educators (AE-Cs) engaged in implementing H-VAMP, however, recruiting sufficient numbers of Spanish-speaking educators to conduct home visits proved difficult.
Solution: Increase number of bilingual volunteers. To help overcome this hurdle, Asthma Allies recruited bilingual volunteers and trained them to assist its AE-Cs. The volunteers also receive the incentive of hours of experience gained toward the 1,000-hour requirement to sit for the National Asthma Educator Certification Board exam.
Challenge: Provider collaboration. Although some clinicians supported H-VAMP's efforts to reinforce patients' adherence to physician-prescribed treatment plans from the start, Asthma Allies recognized that it needed to work harder to build collaborative relationships with additional clinicians who could refer newly diagnosed patients into the program and provide those patients with ongoing follow-up care.
Solution: Develop marketing kit. To address this issue, Asthma Allies developed a marketing kit, with a cover letter, program flier, and referral forms, and used it in conducting outreach to allergists and to primary care and pediatric physicians. This effort succeeded in increasing physician referrals of patients to H-VAMP while also bridging communication gaps among patients, health care providers, and H-VAMP's asthma educators.
Romelia Rodriquez Walters reviews project descriptions during a NACI meeting in Baltimore, MD.
H-VAMP reached over 700 patients, providers, and volunteers through conference presentations, workshops, and home visits.
Asthma Allies received an award from the Greater Albuquerque Chamber of Commerce for its innovative solution to meet the needs of people with asthma in the Albuquerque community.
Asthma Allies shared and collaborated with additional NACI- funded projects to advance asthma care best practices. For example:
During a webinar discussion with other NACI-funded projects on practice redesign to enhance implementation of the six Guidelines Implementation Panel priority messages, Asthma Allies shared its experiences with a program that brings asthma clinic days to children with asthma in rural New Mexico.
A multidisciplinary team now guides patients and their families through a well-ordered series of steps, including assessment, clinical exam, and self-management education, that have allowed it to increase both the number of children served and their asthma control. Many of the patients served had never seen an asthma specialist or had a spirometry test prior to participating in the program.
Asthma Allies used home-visit interventions and provider education to meet its project goals.
Other NACI-funded projects that used Asthma Allies-type approaches are: