Stories about: Community Asthma Initiative

Getting in the ring with asthma

Joel110-year-old Joel was diagnosed with asthma at age 2, which was difficult news for his mother Ellis, but not at all surprising. “Joel’s father, aunt and grandmother are all asthmatic,” says Ellis. “His father recently was hospitalized due to his asthma, but thankfully he’s doing better now.”

For years, Joel used an inhaler to increase airflow to his lungs and control his asthma attacks. But as he got older, his symptoms worsened, and the inhaler wasn’t helping. At age 6, a severe asthma attack landed Joel at Boston Children’s Hospital Department of Emergency Medicine with the risk of a collapsed lung. After spending two weeks in the hospital, Joel was released home and referred to Boston Children’s Community Asthma Initiative (CAI)—a free program that helps Boston-area families manage their child’s asthma at home.

Read Full Story

Translating medicine into real life

Claire McCarthy, MD

The Boston Globe recently reported on a Children’s Hospital Boston study that shows a preventative approach to treating asthma can keep kids out of the Emergency Department (ED) and save money on health care spending. Here, Dr. Claire talks about the medical professionals whose commitment to keeping children healthy supports these innovative approaches to medicine.

I have known Susan Sommer, a nurse in the Community Asthma Initiative (CAI) at Boston Children’s, for nearly twenty years—we met at Martha Eliot Health Center when we were both working there. I was so happy when she started working with CAI, because she is the perfect person to do that kind of work. There are three things that are undeniably true about Susan. First, she really cares about people. I mean really cares, as if each and every one of us were family. Second, she’s really smart. Third, she gets real life.

That last one isn’t to be taken for granted, especially when we’re talking about medical professionals. Sadly, it can be said about us that we often have our heads up in the clouds. We prescribe things based on science and studies—which is good, don’t get me wrong, medical treatments should be based in science and studies. But when patients leave the hospital and go home, real life has a way of, well, getting in the way.

Read Full Story

Home visits for asthma: a win for both patients and payers

Marquis and his mother (middle) received educational home visits from Children’s nurse manager Massiel Ortiz

The journal Pediatrics released a study from Children’s Hospital Boston that shows a preventative approach to treating asthma can keep kids out of the Emergency Department (ED) and save money on health care spending.

The study is based on data collected by Children’s Community Asthma Initiative (CAI), which has been working closely with low-income residents of Boston with asthma since 2005. By sending nurse practitioners and community health workers into the homes of families whose children are frequently hospitalized for asthma, Children’s staff was able to identify asthma triggers in the families’ homes and offer education on avoiding them.

For example, a mother who cleans every inch or her home but then places the broom and duster back in the closet could still be exposing her child to asthma inducing mites. Trained CAI staffers, many of whom have asthma themselves, teach participants the proper way to clean a house to fully remove dust and other potential asthma triggers like pest droppings and mold. The program also provides special coverings for bedding and vacuum cleaners with specific, asthma fighting filters, free of charge.

Read Full Story

Children’s and Blue Cross Blue Shield usher in new age of quality-based benchmarks in pediatrics

Sandra Fenwick, president and COO

I’ve worked at Children’s Hospital Boston for more than a decade, and I’m still inspired every day by the hope and strength I see on the faces of our patients and their families. As Children’s navigates a challenging and evolving health care landscape, I draw on that inspiration and determination, especially when many in our industry seem to imply that cost is the only measure of a hospital’s worth.

At Children’s, our worth—our value—is so much more than just dollars and cents. It means being treated by pediatric experts—doctors, nurses and support staff—who understand that children are not small adults and their care needs to reflect that fact. It’s a commitment to care and innovation that produces programs like our Community Asthma Initiative, which helps children with asthma have fewer attacks so they miss less school and their parents miss fewer days of work.

And it’s about a commitment to constantly improving the quality of the care we deliver. To that end, I am pleased to announce that we have signed an innovative new contract with the state’s largest health insurance provider, Blue Cross Blue Shield of Massachusetts (BCBSMA).

This agreement, known as an Alternative Quality Contract (AQC), calls for us to reach quality targets based on national pediatric quality benchmarks—the first such contract in the country—and keeps the contract value well below medical inflation

The AQC has specific quality measures in the areas of primary care (prevention and treatment), effectiveness of treatment for patients with certain conditions or needs (cystic fibrosis, dialysis or general surgery needs) and safety (central line infections). In addition, we have agreed to accept a 0 percent rate increase in the first year and an average 1.5 percent annual increase over the three years of the contract.

Since 2009, Children’s has taken more than $125 million out of the health care system to benefit insurers, employers and consumers

This contract is aligned with our efforts over the last three years to improve quality  while slowing the rising cost of care delivery. Since 2009, Children’s has taken more than $125 million out of the health care system to benefit insurers, employers and consumers. We have reduced insurers’ rates and prices, become more efficient and have innovated new ways to deliver care that improve quality while lowering costs. In addition, we have moved care to lower-cost settings within the hospital and to our less expensive suburban satellites and community hospital partners, and have improved care integration between primary care physicians and hospital subspecialists.

As far as I’m concerned, the greatest indication of Children’s value is the trust of the parents who place more than 170,000 children in our care each year. Whether they come to us from around the block, or the other side of the world, Children’s takes great pride in knowing that every patient who comes through our doors will receive the same level of world-class care that has made Children’s a leader in pediatrics for more than 140 years.

For more on the Blue Cross Blue Shield deal, read Sandra Fenwick’s interview with WBUR.

Read Full Story