Impact Asthma D.C. Grants

The IMPACT DC Asthma Clinic is an asthma intervention program providing comprehensive care to children referred from the Emergency Department (ED) and inpatient units at CNMC, and from community practitioners, school nurses and managed care case managers.

The IMPACT program is led by a team of providers who have gained national recognition in the development of a model for asthma care. The program provides clinical care and education to approximately 500 asthmatic children admitted to Children’ National. Staffed by a group of 16 faculty members, it addresses the over-dependence on the Emergency Department by inner city families. By emphasizing to families that asthma is a chronic disease rather than an episodic problem and that a combination of preventive measures and longitudinal care are crucial. The intervention improved outcomes in multiple domains, including fewer subsequent visits to the ER, greater reduction of exposure to harmful environmental triggers (like tobacco smoke) and increase use of medications to prevent symptoms.

The IMPACT model uses a unique “intervention” approach wherein they invite children back to their clinics after they are seen for (or diagnosed with) asthma-related issues during a hospital-based intake. The children are typically re-seen between 1 – 3 times, then after the IMPACT staff feels that the family is fully educated and appropriately invested in disease management, they are referred out to their PCP. This model has been proven successful in greatly reducing the use of/need for the ED in pediatric asthma patients. Currently, 100% of the patients (presenting with asthma) who are seen at the Goldberg Centers will have their status entered into the Electronic Medical Record (EMR).

The Children’s Health Board has been a long time contributor to IMPACT Asthma DC. The Board contributed to the initial cost of Asthma Educator’s salary to get the program started. Subsequent grants funded computer equipment and software that have given staff the tools to enter full patient data during Clinic visits. The date is then fully integrated into the Electronic Medical Record used by the child’s primary care provider. The Board has provided tote bags with the IMPACT DC logo that include asthma action plans and printed materials that assist families in keeping all of their asthma materials organized and highly visible. During a clinic visit, families receive materials such as spacers, med. samples, allergen-barrier pillow and mattress covers and a folder with written information. By assisting families to organize these materials in a portable bag, the necessary medications, devices and information will be accessible when needed both on a daily basis and in the case of an emergency.

Benefits from real-time electronic capture include:
  1. Freeing-up of educator staff time now spent scanning paperwork
  2. Ability to better manage patient care and outcomes, as the data will be real-time linked into the EMRs that 100% of CHC patients now have
  3. Data will go real-time into the DC school system, as school nurses also have access to the EMRs
  4. Data can be “mined” and used in cross-department, cross-discipline, and cross-institution research
  5. During consultations, the staff at the IMPACT centers will have immediate access to the patient’s full primary care record, including visits, medications, and immunization history. (Also worth noting is that IMPACT is now reaching out into the broader primary care community – if PCPs in the community agree to utilize the EMR system, they are given the software free-of-charge.)
IMPACT is currently a successful and integral part of the CHC healthcare model, and continues to greatly enhance the care of asthmatic children as part of an innovative, integrated model of intervention.
Benefits from real-time electronic capture include:

  • Freeing-up of educator staff time now spent scanning paperwork
  • Ability to better manage patient care and outcomes, as the data will be real-time linked into the EMRs that 100% of CHC patients now have
  • Data will go real-time into the DC school system, as school nurses also have access to the EMRs
  • Data can be “mined” and used in cross-department, cross-discipline, and cross-institution research
  • During consultations, the staff at the IMPACT centers will have immediate access to the patient’s full primary care record, including visits, medications, and immunization history