Getting the GIST: Asthma Guideline Implementation Steps & Tools
by Karla Stoermer-Grossman MS, RN, AE-C
The Asthma Guideline Implementation Steps & Tools (GIST) program combines provider education and practice redesign to improve the use of asthma guideline-based care by physicians. Funded through the National Asthma Control Initiative (NACI), a Michigan team of experts in the fields of asthma and practice redesign created simple, focused tools to help clinicians make decisions based on the guidelines, and incorporate these tools into their everyday practice so that optimal asthma care is standard. The tools are for both pediatric and adult patients.
Specifically, the tools and procedures help:
- diagnose asthma accurately with an initial assessment of asthma severity and initiate treatment accordingly
- prescribe inhaled corticosteroids (ICS) for patients who are diagnosed with persistent asthma, short-acting beta-agonist for all asthma patients
- provide a tailored asthma action plan and review it at each follow-up visit with the patient
- assess a patient's asthma control and adherence to his/her treatment plan at each subsequent doctor's visit, and address barriers to self-management
The tools have been finalized and the program is completing its pilot practice phase. One practice increased its action plan use by 50%, and appropriate prescription of ICS by 25% in just six months. The next phase for GIST, using local champions to widely promote GIST and use the tools in new practices, is also being funded by NACI.
As part of this distribution phase, the Michigan Department of Community Health is seeking five health care practices to adopt the program in October 2011. Each practice will implement the tools and then track their implementation progress for six months. Practices will receive: technical assistance from asthma experts to help them meet practice goals for asthma, financial incentives for participation; participation in on-site learning sessions at start-up and as needed; evaluation and implementation support throughout the pilot period; and opportunities to learn more about asthma and state and local asthma resources. Any practice is welcome to implement the program, but preference for the five mini-grants will be given to safety net practices and those in high asthma burden areas (Genesee, Ingham, Saginaw and Wayne Counties).
The GIST materials and more about the program
are now available to everyone. Practices are welcome to make changes to the materials to make them more effective for their systems and patients. Contact Tisa Vorce
or 517.335.9463 with any questions.
Karla Stoermer-Grossman is a Clinical Care Coordinator with the Pediatric Asthma Disease Management Program through the Pediatric Pulmonlogy Division at C.S. Mott Children's Hospital. She has been a Certified Asthma Educator for 8 years, and is active with the Asthma Initiative of Michigan.