The goal of this study was to assess institutional climate and providers' readiness to adopt pediatric pathways for asthma treatment and management. Twelve focus groups were held with 24 physicians/physicians' assistants, 20 nurses, and 17 emergency medical technicians from emergency departments in 4 general hospitals from July to October 2002. Positive experience with previous pathways, open communication and buy-in from clinicians and administrators, comprehensive training on pathways, and adapting standards to fit specific emergency department environments were identified as necessary elements for pathway adoption. Providers were optimistic about successfully implementing an asthma pathway (95%) and supportive of pathway implementation (87%).