Interventions to Reduce Over-Utilized Tests and Treatments in Bronchiolitis

Pediatrics
Amy TylerLalit Bajaj

Abstract

The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis. The team used a multidisciplinary kickoff event to understand the problem and develop interventions, including sharing provider-specific data and asking providers to sign a pledge to reduce use. We used a novel, real-time data dashboard to collect and analyze data. Special cause variation on control charts indicated improvement for all outcomes for inpatients during the intervention season. Pre- and postanalyses in which we compared baseline to intervention values for all admitted patients and patients who were discharged from the emergency department or urgent care revealed a significant reduction in the ordering of chest radiographs (from 22.7% to 13.6%; P ≤ .001), respiratory viral testing (fr...Continue Reading

Citations

Sep 19, 2019·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Mario A ReyesRicardo Quinonez
Aug 29, 2019·Pediatric Pulmonology·José Fontoura-MatiasInês Azevedo
Apr 22, 2020·JAMA : the Journal of the American Medical Association·Christine C Cheston, Robert J Vinci
Nov 7, 2019·Pediatric Emergency Care·Javier Tejedor-SojoShabnam Jain
Aug 27, 2019·Journal of Paediatrics and Child Health·Joanna G LawrenceHarriet Hiscock
Oct 28, 2020·Hospital Pediatrics·Mersine A BryanRita Mangione-Smith
Oct 4, 2019·Pediatric Quality & Safety·Aimee Pugh-BernardLeigh Anne Bakel
Nov 2, 2019·Archives of Disease in Childhood·Marta MontejoJavier Benito
Mar 24, 2021·Hospital Pediatrics·Courtney CharvatRebecca Sanders
Jun 29, 2021·Pediatric Quality & Safety·Shaila SirajShawn Ralston
Jun 16, 2021·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·David Andina MartínezRaquel Jiménez García
Aug 18, 2021·The Milbank Quarterly·Betsy Q CliffShoou-Yih Daniel Lee
Sep 9, 2021·Hospital Pediatrics·Gabrielle HesterKelly R Bergmann
Mar 5, 2021·Annals of the American Thoracic Society·Brittany L ShutesTodd J Karsies
Oct 21, 2021·Hospital Pediatrics·Michael J TchouRicardo Quinonez
Jul 15, 2020·Pediatrics·Amy ZipurskyUNKNOWN PEDIATRIC EMERGENCY RESEARCH NETWORKS (PERN)
Aug 5, 2021·Pediatrics·S Barron FrazierDavid P Johnson

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