Sustainability in the AAP Bronchiolitis Quality Improvement Project

Area of Science:

• Pediatrics
• Quality Improvement
• Healthcare Management

Background:

• Adherence to American Academy of Pediatrics (AAP) bronchiolitis guidelines improved via the Bronchiolitis Quality Improvement Project (BQIP).
• The study assesses the sustainability of these improvements one year after the collaborative concluded.

Purpose of the Study:

• To evaluate the long-term maintenance of quality improvements in pediatric bronchiolitis care following a multi-institutional collaborative project.
• To determine if gains in guideline adherence and quality measures persist beyond the active intervention phase.

Main Methods:

• Twenty-one multidisciplinary teams collected monthly data on key inpatient bronchiolitis measures.
• Data from 2275 encounters (995 baseline, 877 intervention, 403 sustainability) were analyzed using generalized linear mixed-effects models.
• Nine sites provided sustainability data one year post-collaboration.

Main Results:

• All key quality measure improvements achieved during the intervention were maintained in the sustainability season.
• Orders for intermittent pulse oximetry significantly increased from 40.6% to 79.2% during the sustainability period.
• Sites participating in the sustainability season showed similar characteristics to those that did not.

Conclusions:

• Participating sites sustained improvements in key bronchiolitis quality measures for one year after the BQIP concluded.
• This collaborative model, providing best-practice toolkits and building local quality improvement capacity, can lead to persistent performance gains.