Staffed by pulmonologists, allergists, public health staff, and an extensive translation services program—with over 30 languages spoken—Boston Medical Center’s (BMC) collaboration with the Boston Public Health Commission (BPHC) provides excellent clinical and environmental care and promotes improved asthma self-management for the city’s underserved populations. The program educates patients about asthma management and environmental triggers, facilitates access to needed services (medical legal partnership, housing, and insurance), and promotes strong provider-patient relationships that contribute to improved patient outcomes. BMC’s environmental focus includes partnerships with several Boston agencies to launch the Breathe Easy at Home Program, a Web-facilitated program that gives health professionals a way to report potential housing code violations that may worsen patient asthma, and the Boston Inspectional Services Department responds to reports by working with property owners to remediate the situation. In striving to offer effective and accessible primary care and outpatient services, BMC successfully works with their most utilized health plans to provide asthma education and case management services and provides exceptional care without exception. The city of Boston is reaping the benefits of this powerful collaboration. The hospitalization rate for Boston’s children with asthma has decreased 39 percent and emergency department visits are 16 percent lower.
Based on the premise that strong patient-provider interaction is key to asthma management, the Bethlehem Partnership for a Healthy Community identifies and educates high-risk children and their families through the school system, improves access to preventive services and care, and provides up-to-date asthma education to the medical community. In partnership with St. Luke’s Hospital and the Bethlehem Area School District, the initiative helps to manage asthma through multiple access points: school-based health clinics, Open Airways Programs, mobile school health clinics, and St. Luke’s Hospital Clinic. The program educates and supports clinical care teams by providing annual education and training to health care providers and coalition partners. Patient education includes multiple, bilingual home visits and thorough patient follow-up. Working with the Bethlehem Health Bureau, the initiative evaluates homes for environmental triggers while distributing trigger-reducing items (such as mattress covers and green cleaning supplies), provides one-on-one education to families, and assists tenants in contacting landlords in order to correct mold and cockroach issues. Through a successful partnership with Lehigh University, the program expanded to address outdoor air quality during the home visit survey. The initiative has proven to be effective: From 2007-2008, multiple asthma-related pediatric emergency department visits for individual patients decreased by 56 percent.