Hawaii Child Asthma Research to Elevate Standards (Hawaii CARES) is an emergency department (ED) based asthma intervention. The program is implemented in four medical institutions and tracks ED asthma patients systematically, provides asthma education to patients and families, and educates ED staff and community-based health care providers about asthma management. The intervention emphasizes the importance of asthma action plans and long-term control medications, and provides instruction in inhaler use. Patients leave the ED with a short-term action plan and recommendation to follow up with their primary care doctor; information regarding the visit is faxed to the patient’s primary care provider.

The goal of Hawaii CARES is to bring the way asthma is treated in the state up to compliance with national guidelines.

Hawaii CARES has reached thousands of children and families through 182 hospital staff members and 374 primary care physicians trained through provider education sessions. The project enrolled 910 asthma patients. At the time of their emergency department encounter 18% of patients were using controller medication, after the educational intervention the number increased to 43%. There was a 570 percent increase in the number of patients with a written asthma action plan at discharge. A majority of patients had a follow-up appointment with a primary care provider, and the number of patients with persistent asthma decreased during the three-month follow-up period.