Cadmus Knows What Makes Leading Asthma Programs Successful

Watertown, Mass. (July 5, 2007) — Regardless of their geographical location or clinical setting, very successful asthma programs share five important attributes that enable them to deliver high-quality care. Just as important, the high-performing programs that embody these attributes are built, refined, resourced, and ultimately sustained in ways that are remarkably similar, according to Katharine Hastings, the principal at The Cadmus Group, Inc. (Cadmus) who leads the team studying asthma programs nationwide. The result is a highly dynamic system that sustains high-performing asthma control programs that can be replicated to improve health outcomes at individual programs across the country.

Working with the U.S. Environmental Protection Agency’s (EPA’s) Asthma Program, Cadmus first identified the Key Drivers of High Quality Asthma Programs. Additional research into these drivers revealed the components of what has come to be called the System for Asthma Control Program Sustainability. The key drivers are:

• Committed Leader and Champions. Committed leaders and champions can significantly affect an asthma program’s health outcomes when they aggressively promote a program’s core goals, track health and process outcomes and widely disseminate the results, commit to driving the improvement process forward, and take ownership to ensure the successful implementation of a care-improvement process. Program leaders most often are senior-level health professionals and executives who are committed to results-driven process improvement, while champions are often staff-level leaders who take ownership for process-upgrades at the department level.
• Strong Community Ties. Programs that have close ties to the individuals and communities they serve are more likely to improve health outcomes for people with asthma. The most effective asthma programs have strong relationships between program staff, local community leaders, and community-based organizations that serve the target population. Such programs are also highly visible and active in local public health and community development issues in their communities.
• High-Performing Collaborations and Partnerships. Programs that take highly collaborative approaches see improved program sustainability, increased credibility in the community, more community support and buy-in, and better and more strategic program planning and implementation. The most effective asthma management programs are collaborations that include federal, state, and local government agencies, community-based organizations, hospitals, health systems, health plans, and many other groups.
• Integrated Health Care Services. Programs that coordinate care with health care providers and have support from clinical care teams can significantly improve health outcomes for people with asthma. Community-based asthma programs must address the behavioral and environmental aspects of asthma along with the clinical aspects to ensure the care patients receive complies with national guidelines and effectively reduces the burden of asthma.
• Tailored Environmental Interventions. Programs that respond to individual exposures and sensitivity to environmental asthma triggers are more likely to improve health outcomes. The most effective programs help people with asthma learn about the role of environmental management in asthma control and provide guidance on how to manage individual triggers at home, school, and work.

Programs that incorporate the key drivers into sustainable care models follow a similar blueprint for success:

• Building the System.When designing a community-based system for asthma control, program planners select who they will serve, how they will serve them, and what they intend to achieve. Effective programs are continuously “under construction” to refine their care models, expand their services, and improve results. Though their goals, interventions, and target populations may differ, highly effective asthma programs follow a similar framework that includes:
  • Allowing an organization’s mission and strengths to guide program goals and objectives.
  • Aligning program incentives with goals.
  • Listening to the data and learning from the target communities as the program model is selected.
  • Collaborating with community partners to address program objectives.
• Evaluating the System. Programs steeped in a culture of ongoing evaluation build better systems, implement more effective programs, and secure resources more successfully than other systems. To become sustainable, a system needs accurate health and process outcomes data to understand community needs, identify gaps and weaknesses in the existing care system, and support program implementation. As programs evolve, effective leaders follow their evaluation data to determine whether program implementation is proceeding as planned, whether interventions are achieving the desired results, and whether outcomes can be improved by refining the care model.
• Resourcing the System. Programs typically need financial resources and personnel, social capital such as strong partners and community support, and equipment. Highly successful asthma programs include a resource strategy in their earliest program plans and continually demonstrate the program’s value to internal, external, and community funders. Great program leaders ensure that the systems they build are aligned with their resource plans so they can deliver what they promise to the target community and their funders, and then they use their evaluation data to demonstrate their results.

Working closely with our clients at the EPA’s Asthma Program, Cadmus helped identify the key drivers of program effectiveness and the system for asthma control program sustainability by closely studying 10 model asthma programs whose results and quality of care distinguish them among the tens of thousands of organizations active in the national fight against asthma. The model programs represent big-city hospitals, large health care plans, small community clinics, city health departments, rural care centers, and non-profit inner-city organizations. Representatives from the programs attended the first two national asthma forums, which were held during Asthma Awareness Month in 2006 and 2007 in Washington, DC. There they taught their peers how to replicate their success.

EPA sponsored the forum. Cadmus provided strategic consulting and technical support for the conference, including the creation of the Asthma Change Package to tell the model programs’ stories and share common approaches that the very different programs have used to markedly improve public health in their communities.

Over 2 years, more than 500 leaders from the fields of medicine, public health, health insurance, and environmental health have attended the forum, where they discussed strategies for rapidly reducing the burden of asthma in every community in the United States. The hundreds of asthma programs represented at the forum committed to using what they learned to accelerate the pace of improving asthma care in their communities and to quickly demonstrate that their programs are making a difference in the lives of their asthma patients.

About The Cadmus Group, Inc.

Founded in 1983, employee-owned Cadmus (https://cadmusgroup.com) helps government, nonprofit, and corporate clients address critical challenges in the environmental and energy sectors. We provide an array of research and analytical services in the United States and abroad, specializing in solving complex problems that demand innovative, multidisciplinary thinking. Among Cadmus’ major practice areas are Drinking Water and Water Quality, Communications and Social Marketing, Energy Services (including energy efficiency and renewable energy), Risk Assessment, Environmental Impact Assessment and Environmentally Sound Design, and Environmental Management.

Our staff includes scientists; engineers; statisticians; economists; MBAs; marketing, public relations, and communications professionals; attorneys; information technology specialists; and public policy analysts. Many of our senior consultants are nationally recognized experts in their fields and several serve on high-level U.S. government science advisory boards.