I-DECIDE After Bronchiolitis Hospitalization

Purpose

Although automatic follow-up is a nearly universal practice, research has shown that these visits are often unnecessary after hospitalizations caused by bronchiolitis. Despite endorsement by national pediatric authorities, robust evidence, and family enthusiasm for as-needed (PRN) follow-up, it remains substantially underutilized for children hospitalized for bronchiolitis. The goal of I-DECIDE is to compare the effects of two multi-component implementation strategies, both of which aim to (a) increase PRN follow-up prescribing by hospitalists (physicians who care for hospitalized children) and (b) decrease unnecessary follow-up visit attendance by families.

Condition

  • Bronchiolitis Acute

Eligibility

Eligible Ages
Between 0 Months and 24 Months
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Primary diagnosis of bronchiolitis, discharged by a generalist inpatient service from a non-ICU, non-emergency department, non-step down unit

Exclusion Criteria

  • Children with a history of gestational age <28 weeks, chronic lung disease, complex or hemodynamically significant heart disease, immunodeficiency, or neuromuscular disease - Children being discharged with home oxygen therapy

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
Moderate-Resource Implementation Strategy
  • Other: Moderate-Resource Implementation Strategy
    The moderate-resource implementation strategy includes educational outreach (including family-facing materials to support follow-up decision making), audit and feedback (review of clinician performance, captured in a structured report), and materials for clinical decision support.
Experimental
High-Resource Implementation Strategy
  • Other: High-Resource Implementation Strategy
    The high-resource implementation strategy includes all of the moderate resource components, plus two forms of external facilitation: small-group facilitation and expert clinical decision support coach-led facilitation. In total, the high-resource implementation strategy includes educational outreach (including family-facing materials to support follow-up decision-making), audit and feedback (review of clinician performance, captured in a structured report), materials for clinical decision support, small-group facilitation and expert clinical decision support coach-led facilitation.

Recruiting Locations

Children's Memorial Hermann
Houston 4699066, Texas 4736286 77030
Contact:
Wan-Hsuan Chen, MD

More Details

Status
Recruiting
Sponsor
Seattle Children's Hospital

Study Contact

Eric Coon, MD, MS
206-884-1223
Eric.Coon@seattlechildrens.org