Grays Harbor Practice Improves Asthma Care

With the recent departure of four pediatricians from the Grays Harbor area, Dr. Steve Hutton has his work cut out for him as the only pediatrician left in the region. His busy practice sees a high proportion of kids with Medicaid coverage (81%) – more than 2000 patients covered by Molina alone. Still, a deep commitment to quality inspires Dr. Hutton to continuously improve the care his clinic provides for the children in his community.

Learning from an expert
When Dr. Hutton joined the Pediatric Transforming Clinical Practice Initiative, he learned he could get support interpreting spirometry results in order to improve his care for children with asthma. He had performed spirometry tests in the past, but it became a challenge to continue as his practice grew busier and fellow pediatricians moved away.

“When this opportunity came up it was a golden opportunity to get back into doing spirometry,” says Dr. Hutton. “I knew Jim Stout [professor of Pediatrics and Adjunct Professor of Health Services at the University of Washington School of Public Health who leads quality improvement through distance training and feedback technologies] from an asthma program we had worked on together in the past. It was great to be able to get his expertise to read the spirometry.”

Good asthma treatment relies on an accurate assessment of the patient’s lung function, so as Dr. Hutton says, “the first order of business is getting a good test.” That’s where Spirometry 360 comes in. Dr. Hutton’s nurses have been training on the most effective way to use the spirometer so that they get the best test results possible. Results are then transmitted to Dr. Stout for interpretation, which he uses to coach Dr. Hutton and his staff.

Seeing opportunities for improvement
“It’s a tremendous opportunity to have an offsite expert to give you suggestions on how to get a better test,” says Dr. Hutton, with the ultimate goal being better outcomes. “Down the road asthma care is going to be an important quality measure in pediatric medicine as we move toward payment for quality versus volume.”

The practice has been using Spirometry 360 since February, and they are already seeing improvements. “Sometimes we see that what we thought was mild asthma is actually much worse and we need to step up our treatment,” says Dr. Hutton. While it will take time for clinic staff to perfect their use of the spirometer and interpretation of the results, he believes it will be worth the effort.

Because asthma therapy is dependent on exact diagnosis, accurate implementation and interpretation of spirometry is a significant help. “There’s a benefit to the patient when you learn that you need to step up to a more intense therapy,” Says Dr. Sutton, “And as a measure of quality it will be beneficial. It’s got to improve your care.”

Editor’s note: Spirometry 360 scholarships are made available to clinics participating in the Pediatric Transforming Clinical Practice Initiative (P-TCPI). To learn more about the initiative, visit