This article is more than 5 years old. Information may no longer be current.
Quality improvement interventions reduced excessive bronchiolitis care
Click Here to Manage Email Alerts
Quality improvement strategies decreased unnecessary care for hospitalized children with viral bronchiolitis, according to study findings in Pediatrics.
Shawn Ralston, MD, of Dartmouth Hitchcock Medical Center in Lebanon, N. H., and colleagues reviewed 14 studies that assessed active quality improvement interventions vs. usual care among more than 12,000 hospitalized children aged younger than 2 years with acute bronchiolitis.
Shawn Ralston
Overall, quality improvement interventions significantly decreased the number of patients receiving repeated dosing of bronchodilators. The pooled risk difference was 0.16, which indicated 16 fewer patients received repeated bronchodilators per 100 patients hospitalized after quality improvement interventions (95% CI, 11-21). Study participants received 5.3 fewer doses of bronchodilators (95% CI, 2.1-8.4), according to the data.
Quality improvement interventions reduced the proportion of patients who received antibiotics by four fewer patients exposed per 100 hospitalized (95% CI, 0.6-8). Quality improvement interventions also reduced chest X-rays by nine fewer patients exposed per 100 hospitalized (95% CI, 2-15); and systemic corticosteroids by five fewer patients exposed per 100 hospitalized (95% CI, 1-9).
Interventions were associated with a decrease of 0.2 hospital days in 10 of the 14 studies included in the systematic review.
The investigators found no differences in outcomes from studies that used a forcing function, a method that introduces the intervention into a physician’s normal workflow, or educational interventions alone.
“Benchmarks derived from the literature suggest hospitals can do significantly better than current average rates of utilization. Further research may be needed to determine the most effective elements on an intervention and whether the proposed benchmarks are appropriate outside of freestanding children’s hospitals,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts