Improving Patient Care During Poor Air Quality Days

Establishing preparedness plans can equip health systems with tools to support patients during extreme climate events.

How to create a climate plan:

1. Form your team. Designate or hire a Heat or Air Quality Officer. The Officer will oversee the creation and implementation of the plan. Assign someone to fulfill the duties of the Officer in their absence.
2. Create a plan for extreme heat or unhealthy air days that addresses the care and safety of patients. This plan could include monitoring the Air Quality Index (AQI) forecast on AirNow.gov and sending unhealthy air alerts to patients with lung disease. It could include opening a temporary heat relief center. The capacity of your health system will shape your climate plan.
3. Train staff. Educate staff about new protocol and on the health risks of extreme heat and poor air quality, ideally before the extreme heat season begins.
4. Implement your plan. Follow the protocol you have created to support patients during extreme heat or unhealthy air days.
5. Evaluate your plan. During the cooler months, evaluate your plan and make any necessary adjustments for the coming year.

Educational resources:

• 10 Tips to Protect Yourself from Unhealthy Air
• Air Quality Index
• Climate and Your Health | Spanish
• How Particle Pollution Impacts Your Lung
• How Ozone Pollution Impacts Your Lungs
• How Wildfire Smoke Impacts Your Lungs
• Knowing Your Risks During Unhealthy Air Days | Spanish
• Protecting Yourself from Unhealthy Air | Spanish
• Asthma Basics | Spanish
• COPD Basics

Evaluating existing resources
Perform a scan of your existing heat and air quality resources. Ensure that your public-facing resources are written at an 8th grade reading level or lower (as recommended by the American Lung Association) and that they are available in the languages spoken by the populations you serve.

Developing resources
 As you develop educational materials or provide verbal guidance on heat and air quality, remember that patients may not be familiar with these topics in relation to lung health. Avoid the use of jargon and use key messaging that is simple and memorable.

Air Quality Alerts
Issuing alerts about extreme heat and poor air quality helps patients make informed decisions about their health. 

There are multiple methods to send alerts to patients including:

• Using an Electronic Medical Record (EMR) system to identify patients who are part of sensitive groups and sending automated alerts to these patients.
• Sending automated or manual messages through a patient portal.
• Emailing or texting alerts to patients.

The National Association of Community Health Centers recommends being cautious of alert fatigue (2024). You should monitor the frequency of alerts and try to identify why messages are being dismissed. Once you have identified why some messages are being ignored, you can adjust to messaging content or frequency to better meet the needs of your patients.

Lung Health Navigators
The American Lung Association’s Lung Health Navigators support patients living with asthma or COPD and their caregivers in finding trusted, accessible, evidence-based, and accurate information. 

Providing care on poor air quality days
If an individual walks to their doctor’s office or takes public transportation, extreme heat and poor air quality can make it difficult for them to arrive safely. Consider scheduling non-emergency visits outside of extreme heat months or in the early morning to minimize their exposure. If your health system offers telehealth appointments, you could also suggest a virtual appointment (if applicable).