Children’s Hospital Colorado (Children’s Colorado) recognized that a leading cause of infant hospitalization is bronchiolitis: a viral infection that causes swelling of the lower airway and mucus plugging, resulting in various degrees of respiratory distress.
Traditionally, providers often ordered chest x-rays, medication to increase airflow and viral tests to treat the condition – all of which have proven over time to be ineffective in both identifying and treating it. Many instances of inappropriate antibiotic treatment occurred as a follow-up to chest x-rays. This led to increased length of stay (LOS) for patients as well as increased costs.
In order to address this, Children’s Colorado started by assembling a multidisciplinary team focused on reducing unnecessary bronchiolitis testing and treatment. Next, they established a provider pledge to bring the issue to providers’ attention. The team utilized a real-time dashboard which monitored and measured provider feedback and modified their electronic health record (EHR) to improve decision-making and to embed the appropriate clinical pathways.
Measuring Success Through Patient and Provider Feedback
Working closely with community providers and families, staff established expectations for the type of care provided and what care is effective for bronchiolitis treatment. Patient videos and handouts were developed to educate parents about common misconceptions around bronchiolitis.
To gauge the feedback of staff following these efforts, a quality study audit was performed which surveyed 15 hospitalists and 15 emergency physicians with an average of nine years in practice.
“I think seeing your own practice put back in front of yourself with data, benchmarked to peers, is one of the most powerful ways to show people how they’re actually practicing, not just what they think in their head,” shared one respondent. Obtaining this feedback proved to be key in ensuring the initiative’s success.
As a result of the team’s work, Children’s Colorado was able to reduce inappropriate and unnecessary diagnostic tests and treatments for children with bronchiolitis. Results showed a 40 percent decrease in chest x-rays, a 41 percent decrease in the use of bronchodilators and a 22 percent decrease in viral testing with no negative impact on LOS or readmission rates.
HIMSS Davies Award of Excellence
The HIMSS Davies Award of Excellence recognizes outstanding achievement of organizations that have utilized health information technology to substantially improve patient outcomes and value. The HIMSS Davies Award of Excellence is the pinnacle of the HIMSS Value Recognition Program and highlights organizations promoting health information and technology-enabled improvements in patient and business outcomes through sharing evidence-driven best practices on implementation strategies, workflow design, change management and patient engagement.
“Through a multidisciplinary team effort and a pledge with providers, Children’s Hospital Colorado was able to determine a new call to action for bronchiolitis treatment, which reduced unnecessary testing and treatment methods nearly by half,” said Jonathan French, CPHIMS, senior director of quality and value-based care at HIMSS. “For diligent efforts to improve infant patient outcomes, HIMSS is proud to recognize Children’s Hospital Colorado as a 2018 Davies Enterprise Award winner.”
“Children’s Hospital Colorado is proud to be a Davies Award winner. We have a long-standing expectation of utilizing health information technology to improve the care and service we provide to our patients and families,” said Jena Hausmann, president and chief executive officer of Children’s Hospital Colorado. “We have learned from the work of other Davies Award winners and are honored to share our work with others as well.”
Children’s Hospital Colorado will be recognized during the 2019 HIMSS Global Conference & Exhibition, which takes place February 11-15 in Orlando, Florida.
Learn more about how Children’s Hospital Colorado has embraced the value of health information and technology: explore three award-winning use case videos.