Related Experiment Video
Updated: Jul 24, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Pediatric Respiratory Illnesses: An Update on Achievable Benchmarks of Care
Mario A Reyes1, Veronica Etinger1, Carla Hronek2
1Division of Hospital Medicine, Department of Pediatrics, Nicklaus Children's Hospital, Florida International University, Herbert Wertheim College of Medicine.
Insights
This study developed a quality measure set for pediatric respiratory illnesses, finding improvements in care benchmarks but identifying gaps in bronchodilator and chest x-ray use for bronchiolitis.
Area of Science:
- Pediatric healthcare quality assessment
- Respiratory disease management
- Health services research
Background:
- Pediatric respiratory illnesses (PRI) are major causes of hospitalization and emergency department visits in the US.
- A lack of standardized quality measures for PRI care hinders effective assessment.
- This study addresses the need for standardized quality metrics in pediatric respiratory care.
Purpose of the Study:
- To develop a comprehensive measure set for assessing the quality of hospital care for pediatric respiratory illnesses.
- To enable automated data extraction from administrative datasets for quality monitoring.
- To evaluate the performance of the developed measures and establish updated achievable benchmarks of care (ABC).
Main Methods:
- A multidisciplinary expert team curated quality measures from various sources.
- The measure set was applied to administrative data from the Public Health Information System database (2017-2019).
- Achievable benchmarks of care (ABC) and performance gaps were estimated and compared to previous reports.
Main Results:
- The developed measure set includes 94 quality measures for pediatric respiratory illnesses.
- Analysis covered 984,033 episodes of care, with 82.3% discharged from the emergency department.
- Low performance was noted for bronchodilator and chest x-ray use in bronchiolitis, while pneumonia showed improved narrow-spectrum antibiotic use.
Conclusions:
- The Pediatric Respiratory Illness (PRI) report provides crucial performance data and identifies quality of care gaps.
- There is evidence of improvement towards optimal performance for established benchmarks.
- Future research should explore health inequities and the impact of the COVID-19 pandemic on PRI care quality.
Background And Objectives:
Pediatric respiratory illnesses (PRI): asthma, bronchiolitis, pneumonia, croup, and influenza are leading causes of pediatric hospitalizations, and emergency department (ED) visits in the United States. There is a lack of standardized measures to assess the quality of hospital care delivered for these conditions. We aimed to develop a measure set for automated data extraction from administrative data sets and evaluate its performance including updated achievable benchmarks of care (ABC).
Methods:
A multidisciplinary subject-matter experts team selected quality measures from multiple sources. The measure set was applied to the Public Health Information System database (Children's Hospital Association, Lenexa, KS) to cohorts of ED visits and hospitalizations from 2017 to 2019. ABC for pertinent measures and performance gaps of mean values from the ABC were estimated. ABC were compared with previous reports.
Results:
The measure set: PRI report includes a total of 94 quality measures. The study cohort included 984 337 episodes of care, and 82.3% were discharged from the ED. Measures with low performance included bronchodilators (19.7%) and chest x-rays (14.4%) for bronchiolitis in the ED. These indicators were (34.6%) and (29.5%) in the hospitalized cohort. In pneumonia, there was a 57.3% use of narrow spectrum antibiotics. In general, compared with previous reports, there was improvement toward optimal performance for the ABCs.
Conclusions:
The PRI report provides performance data including ABC and identifies performance gaps in the quality of care for common respiratory illnesses. Future directions include examining health inequities, and understanding and addressing the effects of the coronavirus disease 2019 pandemic on care quality.
Related Concept Videos
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:23Acute Respiratory Failure-IV