The power of the first hour: a quality improvement project optimising PEFR monitoring and steroid administration in an Emergency Department setting

<bold>Background:</bold> The National Asthma COPD Audit Programme 19/20 revealed gaps in UK asthma management pathways in the UK. At Medway Maritime Hospital in 2022, only 2.9% received timely PEFR within the first hour of care, and only 25.2% received steroids within the first-hour of care (National NACAP targets: 90% and 95%). <bold>Aim:</bold> To increase the percentage of patients receiving PEFR monitoring and steroid administration within the first hour of presentation by January 2024. <bold>Methods:</bold> Two PDSA cycles from 10/9/23 - 14/01/24 focused on ED staff engagement, education, and increasing peak flow supplies. Data was statistically analysed and evaluated through the utilisation of run charts. <bold>Results:</bold> Data from 42 participants, collected retrospectively from Electronic Patient Records, showed a significant improvement in steroid administration within the first hour, reducing hospital admissions. PEFR results remain inconclusive, needing further monitoring. <fig><object-id>erj;64/suppl_68/PA401/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusion:</bold> Overall, the results are very promising and show our interventions made a notable change in patient outcomes. They have set solid groundwork for further work to be conducted in this area.