Evaluation of a quality improvement collaborative in asthma care: Does it improve processes and outcomes of care?

Matthias Schonlau, Rita Mangione-Smith, Kitty S. Chan, Joan Keesey, Mayde Rosen, Thomas A. Louis, Shin Yi Wu, Emmett Keeler

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


PURPOSE: We wanted to examine whether a collaborative to improve asthma care influences process and outcomes of care in asthmatic adults. METHOD: We undertook a preintervention-postintervention evaluation of 185 patients in 6 intervention clinics and 3 matched control sites that participated in the Institute for Healthcare Improvement Breakthrough Series (BTS) Collaborative for asthma care. The intervention consisted of 3, 2-day educational sessions for teams dispatched by participating sites, which were followed by 3 action periods during the course of a year. RESULTS: Overall process of asthma care improved significantly in the intervention compared with the control group (change of 10% vs 1%, P = .003). Patients in the intervention group were more likely to attend educational sessions (20% vs 5%, P = .03). Having a written action plan, setting goals, monitoring peak flow rates, and using long-term asthma medications increased between 2% and 1.9% (not significant), but asthma-related knowledge was unchanged for the 2 groups. Patients in the BTS Collaborative were significantly more likely to be satisfied with clinician and lay educator communication (62% vs 39%, P = .02). Health-related quality of life, asthma-specific quality of life, number of bed days caused by asthma-related illness, and acute care service use were not significantly different between the 2 groups. CONCLUSIONS: The intervention was associated with improved process-of-care measures that have been linked with better outcomes. Patients benefited through increased satisfaction with communication. Follow-up of patients who participated in the intervention may have been too brief to be able to detect significant improvement in health-related outcomes.

Original languageEnglish (US)
Pages (from-to)200-208
Number of pages9
JournalAnnals of family medicine
Issue number3
StatePublished - May 2005


  • Asthma
  • Breakthrough series collaborative
  • Chronic care model
  • Chronic disease
  • Evaluation studies
  • Outcomes and process assessment (health care)
  • Process of care

ASJC Scopus subject areas

  • Family Practice


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