Reduction in Resources and Cost for Gastroenteritis Through Implementation of Dehydration Pathway

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Quality Improvement
• Clinical Guideline Implementation

Background:

• Gastroenteritis management in pediatric emergency departments (EDs) impacts resource utilization.
• Algorithmic care via evidence-based guidelines (EBGs) is increasingly adopted.
• The study addresses the need to optimize care for pediatric gastroenteritis.

Purpose of the Study:

• To evaluate the impact of implementing a dehydration EBG in a pediatric ED.
• To determine if the EBG reduced intravenous (IV) fluid administration.
• To assess the effect on the cost of care for gastroenteritis patients.

Main Methods:

• A single-center quality improvement initiative from 2010-2016.
• An EBG was implemented, assigning dehydration scores and rehydration strategies.
• Statistical process control methods analyzed the proportion of patients receiving IV fluids and episode costs.

Main Results:

• IV fluid use decreased from 15% to 9% post-implementation in 7145 patients.
• Average healthcare costs per episode decreased from $599 to $410.
• Improvements observed in ED length of stay, admission rates, and 72-hour return visit rates.

Conclusions:

• Implementing an EBG for pediatric gastroenteritis is effective.
• The EBG led to decreased IV fluid administration and lower healthcare costs.
• The initiative also improved ED efficiency and patient outcomes.