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. |