A Multicenter Collaborative to Reduce Unnecessary Care in Inpatient Bronchiolitis

BACKGROUND AND OBJECTIVE: Evidence-based gGuidelines for acute viral bronchiolitis recommend primarily supportive care, but unnecessary care remains well documented. Published quality improvement work has been accomplished inchildren’s hospitals, but little broad dissemination has been reported outside of those settings. We sought to use a voluntary collaborative strategy to disseminatebest practices to reduce overuse of unnecessary care in children hospitalized for bronchiolitis in community settings. METHODS: This project was aquality improvement collaborative consisting of monthly interactive webinars with online data collection and feedback. Data were collected by chart review for 2 bronchiolitis seasons, defined as January, February, and March of 2013 and 2014. Patients aged RESULTS: There were 21 participating hospitals contributing a total of 1869 chart reviews to the project, 995 preintervention and 874 postintervention. Mean use of any bronchodilator declined by 29% ( P = .03) and doses per patient decreased 45% ( P P P = .04). Chest radiography use declined by 44% ( P = .05). Length of stay decreased 5 hours ( P CONCLUSIONS: A voluntary collaborative was effective in reducing unnecessary care among a cohort of primarily community hospitals. Such a strategy may be generalizable to the settings where the majority of children are hospitalized in the United States.