Through clinical experience and more formal research methods (User Centered Design), the team recognized the impact hardships (i.e., financial, mental health) had on asthma management. We determined from our patients and by working with social services from across the hospital that inability to obtain needed medications, transportation problems, and mental health problems were the most prevalent and serious problems affecting families’ ability to meet medical needs. Therefore, we selected three major areas to address:
- In collaboration with community agencies we clarified processes and developed algorithms and tools to enhance the success of mental health referrals. By January 2011, the Lab was implementing these processes with >95% reliability. The tools and processes were spread to the entire Teen Health Center.
- The team investigated medical transportation options available through insurance and public sources. In collaboration with families, we developed a simple brochure that explains their benefits and delivered it with 95% reliability to all eligible patients. It was then made available throughout Cincinnati Children's.
- We worked with financial counseling and the pharmacy to clarify requirements and improve processes for obtaining medication when families lacked coverage. We systematically identified patients without medication coverage and successfully obtained medication for all patients in need. In addition, Financial Counseling extended its hours to ensure availability to the end of the Clinic day.