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Decreasing Time to Full Enteral Feeds in Hospitalized Children With Medical Complexity Experiencing Feeding

Abigail Musial, Amanda Schondelmeyer, Owen Densel

    Hospital Pediatrics
    |August 29, 2022
    PubMed

    Insights

    A new feeding algorithm significantly reduced the time to reach goal enteral feeds for children with medical complexity (CMC) hospitalized with feeding intolerance. This quality improvement initiative shortened the median time from 3.5 to 2.5 days, improving care efficiency.

    Area of Science:

    • Pediatric Gastroenterology
    • Quality Improvement in Healthcare
    • Medical Complexity Management

    Background:

    • Children with medical complexity (CMC) often experience feeding intolerance, leading to prolonged hospital stays.
    • Gastrostomy and jejunostomy tubes are common in CMC, but feeding intolerance presents significant challenges.
    • Current feeding intolerance management can prolong length of stay (LOS) for hospitalized CMC.

    Purpose of the Study:

    • To decrease the median time to reach goal enteral feeds in hospitalized CMC with feeding intolerance.
    • To improve the efficiency of feeding resumption for CMC patients.
    • To reduce potential delays in care associated with feeding intolerance.

    Main Methods:

    • A single-center quality improvement project was conducted by a multidisciplinary team.
    • Key interventions included a standardized feeding intolerance algorithm, provider education, and parental engagement.
    • Plan-do-study-act cycles and run charts were used to track progress and outcomes.

    Main Results:

    • Median time to goal enteral feeds decreased from 3.5 to 2.5 days within 6 months for CMC patients.
    • This improvement was sustained for one year post-implementation.
    • No significant change in median length of stay (LOS) was observed.

    Conclusions:

    • A standardized feeding intolerance algorithm effectively reduced the time to achieve goal enteral feeds in hospitalized CMC.
    • Provider education and a systematic approach are crucial for successful implementation.
    • Future efforts aim to integrate the algorithm into electronic health records and expand its use to other services.
    Abstract

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