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Effect of RSV bronchiolitis practice guidelines on resource utilization
A M Harrison1, N M Boeing, J B Domachowske
1Department of Pediatric Critical Care, Cleveland Clinic Children's Hospital, OH, USA.
Insights
Implementing respiratory syncytial virus (RSV) practice guidelines for bronchiolitis in children reduced hospital resource use. These guidelines streamlined care, leading to fewer treatments and less monitoring for RSV patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Health Services Research
Background:
- Respiratory syncytial virus (RSV) bronchiolitis is a common cause of hospitalization in infants.
- Variability in clinical practice for RSV bronchiolitis may lead to increased resource utilization.
- Standardized practice guidelines can potentially optimize patient care and resource management.
Purpose of the Study:
- To evaluate the impact of implementing RSV practice guidelines on resource utilization in hospitalized children.
- To determine if guidelines simplified and streamlined care for infants with RSV bronchiolitis.
Main Methods:
- Retrospective chart review of pediatric patients under 24 months hospitalized with RSV bronchiolitis.
- Comparison of resource utilization before and after the institution of RSV practice guidelines.
- Analysis included albuterol assessment, oxygen use, cardiorespiratory monitoring, and discharge medications.
Main Results:
- Fewer patients received supplemental oxygen and cardiorespiratory monitoring after guideline implementation.
- A documented physician's assessment of albuterol response became more likely post-guidelines.
- Overall resource utilization, including albuterol treatments and discharge regimens, decreased significantly.
Conclusions:
- Institution of RSV practice guidelines led to decreased resource utilization for hospitalized children with RSV bronchiolitis.
- Guidelines appear to simplify and streamline the management of this heterogeneous patient population.
- Standardized care pathways can improve efficiency in managing common pediatric respiratory infections.
Abstract:
We sought to determine whether institution of respiratory syncytial virus (RSV) practice guidelines decreased resource utilization for a heterogeneous population of children hospitalized with RSV bronchiolitis. Patients less than 24 months old with RSV bronchiolitis at a pediatric referral center were identified by retrospective chart review for consecutive RSV seasons. Before the guidelines were instituted patients were less likely to have a documented physician's assessment of response to albuterol, were more likely to have received supplemental oxygen and cardiorespiratory monitoring, and to be discharged on an albuterol regimen. Patients received more albuterol treatments. After the guidelines were in place fewer resources were utilized in the care of patients with RSV bronchiolitis. RSV practice guidelines may simplify and streamline the care of a heterogeneous population of children with bronchiolitis.
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