Selected PPC Activities

Asthma Management Service

• Program goals for high risk children with asthma:
  • reduce recurrent hospitalizations and emergency room visits
  • improve daily function
• Service targets children with:
  • increased risk for respiratory failure
  • under-treated asthma
  • inadequate environmental preventive measures
  • frequent hospitalizations (>2 years)
• Components of the program:
  • education
  • behavior modification
  • reinforcement of a family centered care program
• Pulmonary team includes
  • a physician
  • an asthma education nurse
  • a pulmonary social worker.

Respiratory Home Care Program

• The program provides services which enable children dependent on highly technical respiratory support to live in their homes and communities.
• The program has minimized hospital days for children and families.
  • Average initial hospital stay prior to the program (1994): 164 days.
  • Average initial hospital stay following transition to home (1994): 28 days.

Second-hand Smoke Initiative

• Exposure to environmental tobacco smoke (ETS) is a significant risk factor for all children, particularly those with lung disease.
• Program goal: reduce the amount of ETS exposure and therefore its impact on the health of children with lung disease.
• Strategy: an outpatient and inpatient educational program for parents and other family members focused on user-friendly strategies to reduce ETS in the home.

Home Asthma Management in Inner Urban Setting

In 1994, the PPC began an asthma outreach pilot project in an inner city satellite clinic in order to:

• improve home management of asthma
• reduce asthma morbidity
• reduce the number of unscheduled health care visits for asthma

Collaboration with county, state & private organizations interested in improving policies for children with chronic respiratory conditions

Continuing Education and Technical Assistance for Families and Professionals

Continuing education sessions for families and professionals conducted by PPC faculty in 2002:

Technical assistance provided by PPC faculty in 2002:

Agencies that received technical assistance from PPC faculty in 2002. PPC trainee involvement is indicated by an asterisk.

History Overview of the Pediatric Pulmonary Centers Nationally and in Washington State

1967

• Thirteen Pediatric Pulmonary Centers established nation-wide to provide specialized care to children with lung disease.
• The Division of Chronic Disease and the National Regional Medical Program funds the Centers.

1973

• The Bureau of Maternal and Child Health takes over support of the PPCs.
• Focus changes to multi-disciplinary teams providing comprehensive coordinated care based at regional university-affiliated referral centers.
• To provide multidisciplinary training, the PPCs add faculty members from the schools of nursing, respiratory therapy, nutrition, and social work.

1980s

• A pediatric pulmonologist joins the PPC faculty and the focus shifts from the newborn to children of all ages with acute and chronic lung disease.
• PPC faculty develop models for multidisciplinary care that maximize clinical and functional outcome for these children and their families.
• Comprehensive care shifts to the home with increasing use of home care equipment and nursing agencies throughout the Washington State.
• Emphasis on regional linkages with other Title V agencies.
• Outreach clinics in Washington, Alaska, and Idaho formalized.
• Standards of care devised for health care providers, such as public health nurses, in the community, schools, and in daycare settings.
• Empahsis on collaborative research and multidisciplinary task forces such as the Asthma Task Force with personnel from the MCH programs in pulmonary, nursing, adolescent medicine, and public health.

1990s

• PPC themes are:
  • leadership
  • legislative advocacy for children with special health care needs
  • primary community-based care of children with chronic handicapping conditions
• PPC is charged with improving systems of care for this population of children.
  • Outcome research is needed to evaluate systems of care in a changing health care environment.
• Adapting to changes in health care, the Seattle PPC focuses on training primary care providers to safely manage increasingly severe and complex diseases.
• Graduate training continues as do specialty clinical services and outreach programs.

2000s

• PPC continues to focus on multidisciplinary leadership
• PPC is concerned with reducing disparities in health care for:
  • rural areas
  • low income & uninsured families
  • ethnic minorities