Implementing Pathways to Improve Pediatric Asthma Care

Summary

Background:

Asthma affects nearly 10% of American children, and is a leading cause of pediatric emergency visits and hospitalizations. Clinical pathways are operational versions of practice guidelines aimed at the hospital management of common illnesses. Single-site studies of pediatric asthma pathways have shown significant improvements in quality of care.

Primary Objective:

To evaluate the effectiveness of clinical pathways for improving quality of care for children with asthma in a diverse, national sample of emergency department (ED) and hospital settings.

Primary Endpoints:

1. Emergency Department: The proportion of eligible children who receive systemic steroids within 60 minutes of ED arrival
2. Inpatient/Hospital: Mean length of hospital stay

Study Design:

This project will be implemented through an established quality improvement collaborative of hospitals across the United States, the Value in Inpatient Pediatrics Network (part of the American Academy of Pediatrics). A cluster randomized design will be employed. Group 1 hospitals will receive a multifaceted implementation strategy that includes: 1) a pathway implementation toolkit, 2) local multidisciplinary champions in the ED and inpatient settings, 3) audit and feedback, 4) educational seminars, and 5) practice facilitation (via teleconference). Group 2 will receive the same intervention with the addition of a mobile app pathway tool.

Conditions

• Asthma

Interventions

BEHAVIORAL

PIPA Intervention Bundle 1

The PIPA intervention bundle 1 includes: 1. Pathway Implementation Toolkit 2. Local Multidisciplinary Champions 3. Audit and Feedback 4. Educational Seminars/Webinars 5. Practice Facilitation

BEHAVIORAL

PIPA Intervention Bundle 2

The PIPA intervention bundle 2 includes: 1. Pathway Implementation Toolkit 2. Local Multidisciplinary Champions 3. Audit and Feedback 4. Educational Seminars/Webinars 5. Practice Facilitation 6. Mobile App

Sponsors & Collaborators

• American Academy of Pediatrics

  collaborator OTHER

• University of California, San Francisco

  lead OTHER

Principal Investigators

• Sunitha V Kaiser, MD MSc · University of California, San Francisco

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2018-01-01

Primary Completion

2019-06-30

Completion

2019-06-30

Countries

• United States

Study Locations