• Family Registers
• Registration clerk verifies insurance

Community Health Worker (CHW)

• Greets the family
• Follows up to find out the family's progress on any goals they may have set at the home visit
• Follows up on any psychosocial interventions that are in progress
• Explains to the family what is expected at clinic and about how long today's appointment will take
• Elicits and addresses any questions about the program or today's visit
• Reviews asthma self-management education as needed per the checklist

Children aged < 6 years

Children aged = 6 years

Clinical case manager and/or medical assistant

• Peak flow (observe technique and provide coaching)
• Perform spirometry
• Give 2-4 puffs of albuteral per physician order, (observe technique and provide coaching). Wait 20 minutes before doing a post bronchodilator spirometry.

Clinical case manager

• Elicits child's/family's issues and concerns about asthma, addresses identified issues and concerns
• Assesses recent asthma control and if notwell controlled, explores reasons for suboptimal control and negotiates goals for improved control
• Assesses self-management skills and provides self-management educational material as needed
• Asks family about their confidence in their ability to self manage

Children aged < 6 years

Children aged = 6 years

Clinician

• Reviews records
• Performs physical assessment
• Interprets spirometry
• Initiates or adjusts medications as needed
• Gives prescription for medications, MDIs, and spacers as needed
• Revises written Asthma Action Plan as needed and reviews with the family how to use it

CHW

• Does post bronchodilator spirometry

CHW

• Does post bronchodilator spirometry

Case conference as needed to review and discuss progress on care plans