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The PIRCH study: pathways for improving respiratory illness care for hospitalized children
Investigator (PI): Kaiser, Sunitha V
Performing Organization (PO): (Current): University of California, San Francisco, School of Medicine, Department of Pediatrics / (415) 476-9181
Supporting Agency (SA): Donaghue Foundation
Initial Year: 2021
Final Year: 2023
Record Source/Award ID: Donaghue/ DF20-702
Funding: Total Award Amount: $437,787
Award Type: Grant
Abstract: Asthma, pneumonia, and bronchiolitis are the top causes of childhood hospitalization in the US, leading to >350,000 hospitalizations and ~$2 billion in costs annually. Poor guideline adherence by clinicians contributes to poor outcomes for children hospitalized with these respiratory illnesses, including administration of unnecessary treatments and tests; and higher risks of prolonged recovery time/stay, transfer to intensive care, and readmission. Pathways are simple, visual diagrams that guide clinicians step-by-step through evidence-based care decisions. Most hospitals implement pathways for one medical condition at a time, but Seattle Children's Hospital developed an intervention for simultaneously implementing multiple pathways for multiple pediatric conditions. This intervention improved guideline adherence and decreased length of stay and costs. This intervention has not been studied in community hospitals, which care for >70% of children nationally. Our goal is to evaluate the effectiveness and implementation of this intervention in community hospitals. In aim 1, we will conduct a cluster-randomized trial in 36 hospitals to determine the effects of the intervention on guideline adherence (2 evidence-based practices for each condition: asthma, pneumonia, bronchiolitis). In aim 2, we will qualitatively study hospitals with higher and lower performance in improving guideline adherence to identify barriers and facilitators of implementation. These studies will provide evidence on an intervention that can leverage implementation resources by tackling multiple pathways and rapidly improve value of care for hospitalized children. We have partnered with VIP (Value in Inpatient Pediatrics, a quality improvement network of >450 hospitals), to conduct this, disseminate, and potentially scale the intervention broadly.
MeSH Terms:
  • Asthma /*therapy
  • Bronchiolitis /*therapy
  • Child
  • Community Hospitals /*organization & administration
  • Evidence-Based Medicine
  • Guideline Adherence
  • * Hospitalization
  • Humans
  • Intensive Care
  • Patient Readmission
  • Pediatric Hospitals /*organization & administration
  • Pneumonia /*therapy
  • Program Development
  • Program Evaluation
  • Randomized Controlled Trials as Topic
  • Respiration Disorders /*therapy
  • United States
  • Washington
Country: United States
State: California
Zip Code: 94143
UI: 20211076
Project Status: Ongoing