Asthma Care Practices in Chicago-Area Emergency Departments: Materials and Methods
Materials and Methods
This study was a cross-sectional, self-administered survey of ED asthma care as reported by the ED medical director or his or her designee. The survey was conducted in 1996 to 1997.
Survey Instrument Development
This survey was conducted as part of the Chicago Asthma Surveillance Initiative (CASI). The survey questionnaire was based on the NAEPP Guidelines and specifically on the instrument used in the US Survey of Emergency Department Childhood Asthma Management Study. This instrument was originally targeted to ED management of children with asthma. The members of the CASI team convened an advisory panel of five local ED physicians, selected in consultation with the Illinois College of Emergency Physicians, to help them expand and modify the existing survey. The panel members represented five different local EDs, two from academic university hospitals, and three from community hospitals. The survey was expanded to address diagnosis and management of asthma for adults as well as other content areas. The new instrument was pilot-tested and revised again after the results of the pilot test were reviewed. www.canadian-familypharmacy.com
The final product was a 73-item self-administered questionnaire for data collection on ED utilization and asthma care practice patterns. The survey addressed five topic areas: (1) demographic characteristics and selected utilization statistics from the hospitals and EDs; (2) asthma assessment practices; (3) asthma treatment practices; (4) discharge and follow-up activities for persons with asthma; and (5) familiarity with, attitudes toward, and utilization of asthma care guidelines/protocols.
The demographic section included questions on the type of ED (ie, general, adult only, or pediatric only), affiliation with accredited emergency medicine residency programs, ED statistics (ie, number of visits, admissions, asthma visits, and asthma admissions), and average duration of ED visit for a person with asthma. The section on assessment practices included questions about use of peak flow measurements, pulse oximetry, arterial blood gas measurements, and chest radiographs in varying situations.