|
I
do not expect anyone to conduct a practice in the exact
way that I do. Hundreds of physicians in different kinds
of facilities have incorporated and customized these
asthma tools to suit their patients and their practices.
Many of the forms can stand alone. I hope that you will
examine this binder and decide what forms and procedures
will aid you in organizing delivery of asthma care.
These asthma charts and forms were first published for
health professionals in 1992. They have been used by
practices throughout the country and improved based
on feedback from professionals and patients. The 2005
edition incorporates improvements in asthma care recommended
in the 2002, 1997 and 1991 NHLBI Guidelines for the Diagnosis and Management
of Asthma. You
may copy any form or article in this binder for use
in your practice except for the Asthma Peak Flow Diary
and the Asthma Signs Diary. The documents may not be
copied for sale or commercial use without written permission
from Pedipress. The three-color diaries are available
from Pedipress
In
the following section, “Getting Asthma Under Control,”
I outline my approach to asthma consultation. I require
patients to prepare extensively before I schedule an
appointment. They must read One Minute Asthma: What
You Need to Know and selected pages from my book, Dr.
Tom Plaut’s Asthma Guide for People of All Ages.
Patients complete a two-page questionnaire and write
a narrative of their asthma history. They also keep
an asthma diary for one week before the visit. This
preparation is essential for the patient to benefit
from the consultation. Because of it, we have little
need to spend time recalling history or covering basic
asthma facts. Instead, we analyze data, discuss problems
and are able to develop a comprehensive treatment plan.
The
2005 edition includes a new section for managed care
practices interested in evaluating their asthma programs.
I have developed a simple form for collecting accurate
asthma statistics, essential for assessing outcomes
for the HMO as a whole. A process form allows practices
to analyze care received by individual patients. Asthma
Charts and Forms contains the office aids you need to
develop and evaluate your own asthma intervention. Contact
Pedipress for more information on asthma educational
materials or asthma interventions.
Thomas
F. Plaut, M.D.
May 2005
Asthma Charts & Forms
for the Physician’s Office & Managed Care
74 Pages of charts, diaries, questionnaires and letters
save time and improve patient compliance.
Introduction
1. Questionnaires: *
First
Asthma Consultation
Asthma Review Visit
2.
Asthma Action Plans: *
Comprehensive, Signs Based
Asthma Action Plan, Signs Based
Comprehensive, Peak Flow Based
Asthma Action Plan, Peak Flow Based
3.
Asthma Diaries:
Asthma Signs Diary
Article: Asthma Signs Diary
Asthma Peak Flow Diary
Article: Asthma Peak Flow Diary
Other Articles:
Asthma Diary Improves Care
Suggestions for Office Staff
Finding a Good Peak Flow Diary
Rating Scale for Asthma Diaries
Why Use an Asthma Diary?
4.
Letters and Instructions: *
First Asthma Consultation
Confirmation letter – What to Expect
Suggested Reading
Review Packets:
Review Letters
Reminder Questionnaire
Appointment Prompt letter
Patient Questionnaire
Long Term Flow Chart
Physical Examination
Flu shot reminder
5.
Patient Education:
Patient Acceptance Means Good Compliance
Using One Minute Asthma to teach patients
Asthma Learning
Rating Asthma Learning Materials
Rating 21 Asthma Pamphlets
6.
Inhaled Steroids: *
Reducing possible side effects from inhaled steroids
Stepping down to the lowest effective dose of inhaled
steroids
7.
Managed Care: *
Article: Managing Asthma Care
Forms for tracking Asthma Statistics:
HMO Data Sheet: Children Under 15 years
HMO Data Sheet: Adults
Analysis of Care for Respiratory Illness: Individual
*
Document included on CD
• Purchase price of $95.00 includes permission
to reproduce comprehensive treatment plans, asthma action plans and other forms, except
the diaries, for limited personal or internal office
use.
Computer CD provided so you can customize forms for
your particular practice. Consent to reproduce does
not extend to other kinds of copying, such as copying
for general distribution, for advertising, or promotional
purposes, for creating new collective works, or for
resale. Pedipress copyright should be cited as follows:
For material used without change, please cite: “From
Asthma Charts & Forms for the Physician’s
Office & Managed Care by Thomas F. Plaut, M.D. ©
Pedipress, Inc. Used with permission.”
If you adapt the material for your practice, please
cite: “From Asthma Charts & Forms for the
Physician’s Office & Managed Care by Thomas
F. Plaut, M.D. © Pedipress, Inc. Adapted with permission.”
|
