Emergency department adult asthma care pathway: healthcare providers' perceived utility and barriers to implementation

Abstract

Clinical pathways provide an outline for evidence-based care and can reduce variation of care across many healthcare settings including the emergency department (ED). The purpose of this study was to examine healthcare providers' perceptions of an ED Asthma Care Pathway (EDACP) and identify barriers to implementation. Following a 6-month pilot implementation of the EDACP, healthcare providers (physicians, nurses, respiratory therapists, and administrators) at 5 Ontario EDs were surveyed about the content, format, and usefulness of the pathway, as well as barriers to implementation. A focus group was convened to further explore these factors. In total, 207 of 338 mailed surveys were returned. Approximately 60% of respondents felt that the pathway was a useful tool, which enabled adherence with asthma guidelines (81%), decreased variation in patient care (79%), decreased uncertainty in patient management (73%), and increased their knowledge of best practice (87%). Time constraints and length of the pathway were common barriers. Healthcare providers perceive the EDACP to be a useful knowledge translation and guideline implementation tool, which promotes best practices. Although barriers to adoption of the tool have been identified, these may guide content revisions and inform the process for a successful provincial implementation strategy.