Standardized Asthma Admission Criteria Reduce Length of Stay in a Pediatric Emergency Department.

Asthma is the most common chronic illness in children and accounts for >600,000 emergency department (ED) visits each year. Reducing ED length of stay for moderate to severe asthmatics improves ED throughput and patient care for this high risk population. The objective of this study was to determine the impact of adding standardized, respiratory score based admission criteria to an asthma pathway on: ED length of stay for admitted patients; time to bed request; overall percent admitted asthmatics; inpatient length of stay; and percent of PICU admissions.This was a retrospective study of a quality improvement intervention. Statistical process control methodologies were used to analyze measures 15 months before and after implementation of a modified asthma pathway (6/2010 to 12/2012; pathway modification 9/2011).Three thousand six hundred eighty-eight patients aged 1 through 18 years who presented to an ED with an asthma exacerbation during the study period were included. Patients were excluded if they were not eligible for the asthma pathway. Patient characteristics were similar before and after the intervention. Mean ED length of stay and time to bed request for admitted asthmatics both decreased by 30 minutes. There was no change in percent of asthma admissions (34%), mean inpatient length of stay (1.4 days), or percent PICU admissions (2%).Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow. This article is protected by copyright. All rights reserved.