P2D253: Streamlining the Clinical Management of Bronchiolitis in a Community Hospital- a Quality Improvement Project

Purpose/Objectives: To streamline the management of bronchiolitis at Brookdale Hospital by decreasing unnecessary interventions by 50% in 6 months.

Design/Methods: Retrospective data was collected from the last bronchiolitis season (Mid-September 2020-March 2021). We implemented a value stream mapping process of current care measures and identified areas for improvement; chest x-ray, albuterol, steroid, and antibiotic use. We have conducted several interventions including 1:1 provider education, printed cards, posters, patient education pamphlets, and EMR smart phrases.

Results: Preliminary data showed a decreasing trend on the control chart, indicating less albuterol and chest x ray usage. There was a significant reduction in albuterol and chest x-ray use after the 4th intervention using real time provider feedbacks and education without increased readmission rates. P value 0.00009 and 0.0013 respectively

Conclusion/Discussion: This multidisciplinary improvement initiative resulted in a significant reduction in use for bronchiolitis care at our institution. Our approach, which included a novel, real-time data dashboard and interventions such as individual providers pledging to reduce use, may have the potential to reduce overuse in other settings and diseases.