Discharge Stewardship in Children's Hospitals

Summary

The goal of this interventional study is to test if a discharge stewardship bundle is effective at reducing inappropriate antibiotic prescriptions at hospital discharge for children with the three common infections: community-acquired pneumonia (CAP), urinary tract infections (UTI), and skin/soft tissue infections (SSTI). The goals of this study are:

* To develop, locally adapt, and implement a discharge stewardship intervention across four geographically diverse children's hospitals.
* To measure the impact of the discharge stewardship intervention on antibiotic prescribing and patient outcome for three common pediatric infections.

Families who are enrolled in the study will be asked to:

* complete a one question wellness track on days 3, 7, and 21 after hospital discharge
* complete a brief survey on days 7 and 21 after hospital discharge

The study team will conduct interviews with the hospitalists at each of the four participating hospitals to create a "discharge stewardship" bundle. Once the bundle intervention is implemented, the hospitalists will be asked to follow prescribing guidelines for CAP, UTI, and SSTI. They will receive regular group-level feedback reports to show how well they follow the guidelines and motivate the hospitalists to follow the guidelines better.

Conditions

• Pneumonia, Bacterial
• Pneumonia Childhood
• Urinary Tract Infections
• Soft Tissue Infections
• Skin Infections
• Community-acquired Pneumonia

Interventions

BEHAVIORAL

Discharge antibiotic stewardship intervention

Hospitalists will be provided with group-level, quarterly feedback reports illustrating the number of prescriptions that had the appropriate antibiotic duration and appropriate antibiotic choice for each of the three conditions.

Sponsors & Collaborators

• Seattle Children's Hospital

  collaborator OTHER

• Primary Children's Hospital

  collaborator OTHER

• St. Louis Children's Hospital

  collaborator OTHER

• University of Pennsylvania

  collaborator OTHER

• Agency for Healthcare Research and Quality (AHRQ)

  collaborator FED

• Children's Hospital of Philadelphia

  lead OTHER

Principal Investigators

• Jeffrey S Gerber, MD, PhD · Associate Professor, Pediatrics

Study Design

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

28 Days

Max Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-06-10

Primary Completion

2025-12-16

Completion

2026-07-31

Countries

• United States

Study Locations