Multisite Emergency Department Inpatient Collaborative to Reduce Unnecessary Bronchiolitis Care

Abstract

Collaboration between ED and IP units was associated with a decreased use of unnecessary tests and therapies in bronchiolitis; top performers used few unnecessary tests or treatments.

Implementing Parental Tobacco Dependence Treatment Within Bronchiolitis QI Collaboratives

“…The resources for both projects were made available on the VIP Network Web site after completion. 14,18 In the BQIP collaborative, the tobacco-dependence treatment interventions recommended were based on the US Department of Health and Human Services (HHS) Clinical Practice Guideline 5 A's approach. 20 In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition combined the terms "abuse" and "dependence" for substances of abuse and used the nomenclature "tobacco use disorder."…”

“…1, 3, 15 -17 The first project was known as the Bronchiolitis Quality Improvement Project (BQIP), 14 and the second was known as the Stewardship in Bronchiolitis (SIB) collaborative. 18 The lessons learned from the first collaborative experience framed the more ambitious aims in the larger SIB collaborative. Researchers in the SIB project added specificity to the tobacco dependence interventions for parents and/or caregivers with a stronger framework for promoting cessation and the inclusion of a recommendation for nicotine replacement therapy (NRT).…”

“…Researchers in the SIB project added specificity to the tobacco dependence interventions for parents and/or caregivers with a stronger framework for promoting cessation and the inclusion of a recommendation for nicotine replacement therapy (NRT). 14,18 The underlying assumption in both projects was that smoking cessation can be promoted in the parents and/or caregivers of hospitalized children by using QI methods and without engaging significant external resources.…”

Pediatric Pulmonology year in review 2018: Asthma, physiology/pulmonary function testing, and respiratory infections

“…The preponderance of evidence indicates that bronchodilators and corticosteroids are not beneficial in acute bronchiolitis, and recent quality improvement studies have documented achievement of reductions in these interventions . Nebulized hypertonic saline in the setting of acute bronchiolitis may have modest benefit .…”

Choosing Wisely® in Pediatric Hospital Medicine: Time to Celebrate?

“…Collaboration between the ED and the Hospital Medicine Unit is essential to tackle the issue of overuse. 4 The study by Reyes et al provides a nice description of the trends in the Choosing Wisely ® overuse metrics at a group of children's hospitals and is one of few such reports. The NIH fund-*Corresponding Author: Sanjay Mahant, MD; E-mail: sanjay.mahant@sickkids.…”