Cluster Randomized Trial of a Moderate vs High Resource Implementation Strategy to Increase As-needed Post-hospitalization Follow-up for Children With Bronchiolitis

Summary

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.

Eligibility

Age range

0–2 years

Sex

All

Healthy volunteers

No

Interventions

• 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.

• 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.

Locations (56)