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"We’ve started seeing over the first 6-8 months some real culture change...with these groups, bringing some quality improvement resources to this area and connect[ing] them with some national resources as well.”
Elizabeth Foley, Quality Improvement Specialist, Medical Care Development (Calais, ME)
Elizabeth Foley discusses how Medical Care Development engaged with a variety of different groups and partners to promote asthma education.
Medical Care Development (MCD) developed the Asthma Practice Improvement Project in collaboration with Calais Regional Medical Services (CRMS) and Calais Hospital in Washington County, Maine. The goal of the project was to improve the care of those with asthma by working with rural medical practices in a learning collaborative model. The project provided medical education based on the Expert Panel Report 3–Guidelines for the Diagnosis and Management of Asthma (EPR-3) and worked to strengthen the tracking of key clinical information for patients with asthma.
An integral part of the Asthma Practice Improvement Project was to engage community programs, schools, and nearby tribal reservations in supporting better awareness and management of asthma. MCD worked to build relationships between health care providers and their local community and to support patients in taking an active role in their asthma care.
Provide medical education based on the EPR-3 guidelines that includes environmental and co-morbid conditions that affect asthma.
Implement asthma care delivery mechanisms within the medical practice.
Assure that asthma care is well understood by patients and families.
Make connections with the community to assure community support for patients with asthma.
Elizabeth Foley (right) discusses Medical Care Development's project with a colleague.
Challenges & Solutions
Challenge: The cost of trainers for educational sessions. To launch its asthma education series for medical staff, public health nurses, and community partners, MCD needed to secure trainers. Initially, it identified trainers from another hospital in the state, however, their services would be expensive, and their style and approach was not a clear match for the intended audiences in Calais.
Solution:Use local and national connections to find trainers. MCD identified a Certified Asthma Educator from another part of the state whose approach seemed more compatible with MCD’s target audiences. It also used opportunities presented by the NACI to reach out to the U.S. Environmental Protection Agency and the National Environmental Education Foundation, a NACI Strategic Partner, to explore additional trainings for various audiences.
Calais Regional Medical Services (CRMS) staff participated in the six-month Spirometry 360 training program offered by the University of Washington, a NACI Strategic Partner, and began implementing spirometry in the pediatric practice.
CRMS invested in hiring a quality improvement project coordinator who oversees training and implementation of spirometry in the pediatric practice and will help spread spirometry to family practice.
MCD increased its engagement with community partners, including signing a memorandum of understanding with the local Healthy Maine Partnership to participate in community outreach.
MCD shared and collaborated with additional NACI-funded projects to advance asthma care best practices. For example:
Medical Care Development teamed with a nurse practitioner who had completed the train-the-trainer program conducted by the National Association of Pediatric Nurse Practitioners, a NACI Strategic Partner. The trainer conducted an education session on asthma best practices for MCD’s hospital and emergency service staff.
To meet its project goals, MCD used provider training and a systems approach to improve the medical management of asthma and to address asthma disparities.
Other NACI-funded projects that used MCD-type approaches are: