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Related Experiment Video

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Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

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Published on: January 16, 2019

Quality improvement project to decrease unnecessary investigations in infants with bronchiolitis in Cork University

Lizeri Jansen^1,2, Gideon-Phil Meyer^3,2, Glenn Curtin³

¹Emergency Department, Cork University Hospital, Cork, Ireland lizerijansen@gmail.com.

BMJ Open Quality

|November 16, 2021

Summary

Implementing an evidence-based protocol significantly reduced unnecessary chest X-rays and lab tests for infants with bronchiolitis. This improves infant care and optimizes healthcare resource use during peak seasons.

Keywords:

emergency department paediatrics quality improvement

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Area of Science:

Pediatrics
Emergency Medicine
Public Health

Background:

Bronchiolitis is a frequent cause of emergency department (ED) visits for infants.
Existing guidelines advise against routine radiological and laboratory tests for bronchiolitis.
A preintervention audit revealed unnecessary investigations were common in infants under 12 months with bronchiolitis.

Purpose of the Study:

To decrease unnecessary investigations in infants diagnosed with bronchiolitis.
To enhance patient care quality by adhering to evidence-based guidelines.
To optimize resource utilization in the emergency department during peak winter seasons.

Main Methods:

A preintervention audit assessed investigation rates (chest X-ray, laboratory tests) and hospital length of stay (LOS) for infants with bronchiolitis.
A multimodal intervention was introduced, including a clinical flowchart and regular performance feedback.
A postintervention audit evaluated the impact of the intervention on investigation rates, LOS, and patient re-representation rates.

Main Results:

The mean weekly chest X-ray rate decreased by 57% (25% to 11%, p<0.05).
The mean weekly laboratory investigation rate improved by 56% (29% to 13%, p<0.05).
Average weekly patient re-representation rates and hospital LOS showed no significant changes.

Conclusions:

An evidence-based protocol effectively reduced unnecessary investigations for infants with bronchiolitis.
The intervention improved diagnostic and management capabilities, enhancing patient care quality.
Reduced unnecessary testing contributes to decreased healthcare costs and efficient resource allocation.