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Michigan Department of Community Health

"This project will enhance existing communication efforts with a concentrated push to raise awareness of the key messages of the asthma guidelines for successful implementation to primary care audiences."

Sarah Lyon-Callo, M.A., M.S., Asthma Investigator, Michigan Department of Community Health

Project Snapshot

Sarah Lyon Callo leads a group discussion at a NACI meeting in Baltimore, MD.
Sarah Lyon-Callo leads a group discussion at a NACI meeting in Baltimore, MD.

Through its NACI Clinical Champions project, the Michigan Department of Community Health's (MDCH) physician champions taught primary care providers in high-burden communities how to use MDCH's Guideline Implementation Steps and Tools (GIST) to help them implement the six priority messages of the National Asthma Education and Prevention Program's Guidelines Implementation Panel (GIP) Report and reduce the burden of uncontrolled asthma on both their patients and practices. This endeavor built upon MDCH's NACI Demonstration Project, which had developed, tested, and refined GIST, a set of materials and practice redesign tools to make it easier for busy primary care providers to use guidelines-based asthma care with their patients of all ages.

With the support of MDCH and its partner, the Asthma Initiative of Michigan, MDCH's champions worked to energize multiple provider education and practice networks, incorporate the six priority GIP messages and GIST into other practice redesign efforts in the state, and develop additional primary care asthma champions. All of MDCH's champions had participated in the Asthma Initiative of Michigan since its inception in 1999, and many of them had contributed their time and expertise to the Michigan Asthma Advisory Committee.

Project Goals

  1. Empower champions to implement GIST in practice redesign, with primary care providers in high-burden communities.
  2. Promote the six priority GIP messages and GIST in the state of Michigan through interactions, networks, and presentations at health professional organizations.
  3. Promote GIST as a national primary care provider resource and develop a universal accreditation package for the tools.

Challenges & Solutions

Challenge: Empower providers to incorporate GIST into their everyday practice. Providers often had questions about how to use GIST, such as how to integrate the tools and materials into their practice workflow or electronic medical records system, or how to find time during an office visit to complete a written asthma action plan with a patient.

Solution: Work individually with each practice to find the best possible solution. MDCH found that a one-size approach to using GIST did not fit all primary practice settings. Instead, MDCH champions provided one-on-one education and coaching to practices, ranging from small safety-net providers to large health care systems, to help them use GIST to make implementation of guidelines-based asthma care easier, more efficient, and more effective.


"I knew they [GIST materials] were good, but having all age group recommendations on one page is very convenient. I've got a lot of plans in motion for full implementation of the tools."

– Physician from one of MDCH's NACI Demonstration Project pilot practice sites.

MDCH provided a brief implementation guide based on the experiences of other practices to help providers get the most from GIST.

MDCH conducted a certified asthma educator (AE-C«) sharing day attended by 35 AE-Cs from Michigan. Feedback from the event's evaluation was overwhelmingly positive, and the group requested similar events in the future.

MDCH's champions presented at five Michigan health professional conferences and displayed a poster at the 13th Annual American College of Chest Physicians Community Asthma and COPD Coalitions Symposium.


MDCH shared and collaborated with other NACI-funded projects to improve asthma care and control. For example:

Building on a connection made between MDCH and the University of Washington (UW) through the NACI, one of MDCH's partners, the University of Michigan Health System, participated in the six-month Spirometry 360 training and feedback program conducted by UW's NACI Strategic Partnership project and became one of five practice sites trained through UW's NACI Clinical Champion project to deliver Spirometry 360 to other practice sites.

MDCH also forged a partnership with the South Bronx Asthma Partnership (SOBRAP)/Bronx-Lebanon Hospital, a NACI Demonstration Project and Clinical Champion. Five Michigan physicians, including one of MDCH's champions, were accepted into SOBRAP's Clinical Asthma Champions Leadership Training program. In addition, MDCH invited SOBRAP to deliver a presentation on "Practice Transformation" at MDCH's Michigan Asthma Partnership Forum.

To meet its project goals, MDCH focused on practice redesign for primary care providers.

Other NACI-funded projects that used MDCH-type approaches are:

Michigan Department of Community Healthexternal disclaimer
Asthma Prevention and Control Program
201 Townsend Street, 4th Floor, PO Box 30195
Lansing, MI 48909

Last Updated January 2013