Table 1: Key Features of the YES WE CAN Care Model
Clinic Elements Clinical Element Details
Number of patients scheduled per asthma clinic session About five to seven patients in combination of both new and return visits
Number of sessions Usually three for each family
Space requirements
  • May be conducted in a pediatric department
  • Need two exam rooms
  • Need a room for families to view a video
  • Need an area to perform spirometry
Length of time for clinic 2 hours
Length of time for each child/family
  • Initial visit: one hour; add 15 minutes for spirometry
  • Return visit: 30 minutes; add 15 minutes for spirometry
Arrival logistics One family is scheduled to arrive every 15 minutes. Example:
  • Three new patients at 1:00 pm, 1:15 pm and 1.30 pm
  • Then three return patients at 1:45 pm, 2 pm, and 2:30 pm
Frequency Weekly or every other week (frequency of clinics and number of patients at each clinic will depend on number of asthma-related ED visits, hospitalizations and high-risk children, and available staff, space etc.)
Staffing
  • Champion (physician or nurse practitioner)
  • Clinical care manager (registered nurse)
  • Community health worker
  • Medical assistant
Supplies/Equipment needed
  • Spirometer and filters
  • Peak flow meter, filter/spacers (for families that don’t bring theirs)
  • Albuterol metered dose inhaler (for post bronchodilator spirometry)
Educational component
  • VCR, TV, and video "Your Child and Asthma"
  • Patient education materials
  • Blood Pressure cuff, stethoscope and scale
  • Teach/return demo for current use of peak flow meter, inhalers, and spacer devices
Clinical component
  • Trigger-avoidance measures
  • Asthma self-management education and skills
  • Vital signs, height and weight
  • Peak flow assessment
  • Pre-and post-bronchodilator spirometry
  • Allergy skin testing
  • Physical assessment of the respiratory system
  • Determination of asthma severity
  • Confirmation of diagnosis
  • Identify asthma triggers
  • Adjust medications as needed
Social component
  • Provide written Asthma Action Plan
  • Determine follow-up needs
  • Identify social barriers and needs
  • Prioritize problems and develop care plan to address needs
Patient flow (initial visit) Registers → community health worker → medical assistant → asthma video → clinical care coordinator → physician/nurse practitioner → community health worker
Case-Conference The asthma team conducts a case conference following the clinic. The staffs share information, identify and prioritize problems, and problem solve as a group to develop or modify the care plan for each family as needed.
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