CAHC program staff recognized that many of the centers work with a large population of children and adolescents with asthma. Health center providers follow the NHLBI asthma care guidelines and communicate regularly
with the child's community primary care provider. An asthma presentation at the Clinician Education Day in the Spring of 2012 reminded center clinicians about the importance of spirometry testing. Very few of the centers had spirometry equipment, and after
learning that few community providers did this testing, CAHC staff wondered if they could help. They started to identify the centers that would benefit most from enhanced asthma education and training, and the addition of a spirometer. Some centers had already
planned to do asthma quality improvement activities, and welcomed the addition of the Spirometry Project.
Forty-two of the seventy sites were chosen and agreed to follow the parameters of the project. They each received a spirometry unit and a full day of education on how to use it, and how to read and interpret
the graphs. Beginning in the Fall of 2012, two staff from each site were trained; the primary care provider (Nurse Practitioner or Physician Assistant) and a Medical Assistant or Registered Nurse.The trainings were conducted by a respiratory therapist with
expertise in spirometry and spirometry education.
Following the training sessions, the trainer and the CAHC Clinical Consultant have been making site visits. At the visits, they make sure that the units are being used correctly and that staff are reading and
interpreting the results accurately. Also, throughout the year, the trainer has been in email and fax contact with the providers, answering questions and verifying the interpretation of tests. Monthly "tips" have been sent to the participating sites in the
form of a newsletter. The health centers have found this technical assistance very helpful and are feeling much more comfortable using the units to diagnose and assess asthma.
Each participating center is reporting quarterly on their spirometry and asthma efforts, tracking the number of tests done compared to the number of known clients with asthma. Year-end reports will be checked
to see if more technical assistance will be needed. CAHC staff is very pleased with the spirometry growth at the centers, and looks forward to additional asthma projects in the future.