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How It Works
Board certified allergists and/or nurse practitioners, nurses, respiratory therapists
and patient service workers provide services on each Breathmobile® including diagnosis,
a physical examination, patient history, pharmacological therapy, free medicine,
spirometry, limited skin testing, as well as peak flow meter testing. A validated
school based screening process provides an efficient method to help identify children
with poorly controlled asthma to be seen on the Breathmobile®. School nurses also
help recruit children with asthma. Every six to eight weeks the Breathmobile® returns
to the school to provide continuous asthma care.
Education
Each Breathmobile® provides patient and parent education that focuses on the proper
use of medicines and the appropriate use of metered dose inhalers, spacing devices
and nebulizer treatments. Environmental control measures, such as the rationale
for the use of bed coverings, are an important educational component. Educational
materials in different languages, along with educational displays and videos help
reinforce concepts presented to the patients by the medical team.
Evaluation
Evaluation studies have demonstrated dramatic improvement for patients treated on
the Breathmobile®. This includes: fewer emergency room visits, improved pulmonary
function, decrease in school absenteeism, and improved quality of life. The data
also suggest that the majority have had significant improvement in their status
within the first 6 months.
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An average of only 2 Breathmobile visits is typically required for patients with
mild and moderate asthma to achieve control, whereas patients with severe asthma
require an average of 3 visits. The program has demonstrated to be an efficient
way to provide care to high risk disadvantaged children.
Pediatric
Asthma Disease Management Program
The care delivered on all the Breathmobiles® is coordinated at the Pediatric Asthma
Disease Management Center at the LAC+USC Medical Center. "The Breathmobile® program
is a wonderful example of synergy between health care organizations that are solely
committed to the improvement of children’s asthma," said Craig Jones, MD, founder
of the program, and one of the principle researchers. Demographic, clinical, and
outcomes information from each of the Breathmobiles® is integrated at this center
where care coordinators contact families to facilitate participation in ongoing
preventive care.
In 2002 the Pediatric Disease Management Center became the first disease specific
care program in the United States to be credentialed by the Joint Commission on
Accreditation of Health Care Organizations (JCAHO). A thorough onsite review of
the healthcare process, data collection, analysis, and performance improvement process
led to the credentialing by JCAHO.
The Breathmobile® has been proven to be an efficient model to provide long term
preventive care to children with asthma. Other cities throughout the nation have
replicated the program. See the links below.
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