IHA case studies

A Method for Sustained Improvement and Control after Initial Implementation of a Bronchiolitis Clinical Care Guideline


Bronchiolitis, one of the most costly and frequent medical diagnoses seen at the hospital, is a seasonal viral infection of the lungs that affects children less than two years of age. A multidisciplinary team was created in December 2013 to implement a bronchiolitis clinical care guideline (CCG). While this guideline was implemented in February 2014 in the observation unit, inpatient floor and emergency room, ownership of the initiative had to be transferred from the hospital quality consultant to the primary stakeholders to ensure that improvement work was sustained and controlled.

Through a multifaceted and team-based approach, the hospital demonstrated a method of sustained improvement for the bronchiolitis CCG by focusing on change management and communication strategies targeted at improving culture. The results show marked and sustained utilization of the CCG by increasing order set utilization from 66 percent post initial implementation to 79.3 percent by the end of the subsequent season, sustaining the initial decrease in bronchodilator utilization from 29 percent to 25.5 percent and sustaining the initial decrease in chest x-ray utilization from 22 percent to 20.5 percent.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine’s six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/

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