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Multicenter quality improvement collaborative reduces unnecessary care for acute viral bronchiolitis

Researchers reduced the rate of bronchodilator, steroid and imaging use, as well as reduced the overall length of stay and readmission rate for patients with bronchiolitis in hospitals that participated in a multicenter quality improvement collaborative, according to recent research.

“Unnecessary care for bronchiolitis was reduced in a voluntary multisite collaborative with a focus on community hospitals,” Shawn L. Ralston, MD, MS, of the Children’s Hospital at Dartmouth in Lebanon, New Hampshire, and colleagues wrote. “The results of this project are potentially generalizable to the settings in which the majority of children are hospitalized in the United States.”

Ralston and colleagues collected data from 21 hospitals, which totaled 1,869 chart reviews across two bronchiolitis seasons between January through March 2013 and January through March 2014, according to the abstract. The chart reviews consisted of 995 pre-intervention cycles and 874 post-intervention cycles.

The researchers reported that overall use of a bronchodilator decreased by 29% (P = .03) and the volume of use also decreased from median 6.9 doses (mean 7.8 doses) to median 3.8 doses (mean 5.5 doses), a decrease of 45% overall (P ≤.01). They also noted that proportion of any steroid use decreased by 68% (P < .01) and steroid doses per patient also decreased by 35% overall (P = .04).

Further, chest radiography decreased by 44% (P = .05) and 36% from baseline, length of stay decreased from 49.6 hours to 44.6 hours (P < .01) and the readmission rate decreased from 2% at baseline to 0% at post-intervention (mean 1.9%). – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.