A System Wide Quality Improvement Project for Bronchiolitis Patients: Integrating Urgent Care, Emergency Department and Inpatient Hospital Care

Introduction In 2014 the American Academy of Pediatrics (AAP) published a revised bronchiolitis guideline recommending against the routine use of bronchodilators, chest x-rays (CXR) and laboratory evaluation in the management of bronchiolitis. Concurrently, four of the five Choosing Wisely® recommendations published by the Society of Hospital Medicine directly addressed the care of infants with bronchiolitis. Bronchiolitis is the third most common admission diagnosis at Children’s Healthcare of Atlanta. We undertook a systemwide quality improvement (QI) initiative across multiple settings where bronchiolitis patients are seen in a large pediatric healthcare system. We report the impact of this QI initiative on the care of bronchiolitis patients. Methods This QI project involved five urgent care (UC) locations, two emergency departments (ED) and two tertiary …