Implementing Pathways to Improve Pediatric Asthma Care
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Asthma |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/6/2019 |
| Start Date: | January 1, 2018 |
| End Date: | June 2019 |
The PIPA Study (Pathways for Improving Pediatric Asthma Care): A Cluster Randomized Trial
Background:
Asthma affects nearly 10% of American children, and is a leading cause of pediatric emergency
visits and hospitalizations. Clinical pathways are operational versions of practice
guidelines aimed at the hospital management of common illnesses. Single-site studies of
pediatric asthma pathways have shown significant improvements in quality of care.
Primary Objective:
To evaluate the effectiveness of clinical pathways for improving quality of care for children
with asthma in a diverse, national sample of emergency department (ED) and hospital settings.
Primary Endpoints:
1. Emergency Department: The proportion of eligible children who receive systemic steroids
within 60 minutes of ED arrival
2. Inpatient/Hospital: Mean length of hospital stay
Study Design:
This project will be implemented through an established quality improvement collaborative of
hospitals across the United States, the Value in Inpatient Pediatrics Network (part of the
American Academy of Pediatrics). A cluster randomized design will be employed. Group 1
hospitals will receive a multifaceted implementation strategy that includes: 1) a pathway
implementation toolkit, 2) local multidisciplinary champions in the ED and inpatient
settings, 3) audit and feedback, 4) educational seminars, and 5) practice facilitation (via
teleconference). Group 2 will receive the same intervention with the addition of a mobile app
pathway tool.
Asthma affects nearly 10% of American children, and is a leading cause of pediatric emergency
visits and hospitalizations. Clinical pathways are operational versions of practice
guidelines aimed at the hospital management of common illnesses. Single-site studies of
pediatric asthma pathways have shown significant improvements in quality of care.
Primary Objective:
To evaluate the effectiveness of clinical pathways for improving quality of care for children
with asthma in a diverse, national sample of emergency department (ED) and hospital settings.
Primary Endpoints:
1. Emergency Department: The proportion of eligible children who receive systemic steroids
within 60 minutes of ED arrival
2. Inpatient/Hospital: Mean length of hospital stay
Study Design:
This project will be implemented through an established quality improvement collaborative of
hospitals across the United States, the Value in Inpatient Pediatrics Network (part of the
American Academy of Pediatrics). A cluster randomized design will be employed. Group 1
hospitals will receive a multifaceted implementation strategy that includes: 1) a pathway
implementation toolkit, 2) local multidisciplinary champions in the ED and inpatient
settings, 3) audit and feedback, 4) educational seminars, and 5) practice facilitation (via
teleconference). Group 2 will receive the same intervention with the addition of a mobile app
pathway tool.
Participant/Local champion Eligibility Criteria:
Inclusion Criteria:
- Working as a physician at the study site
Exclusion Criteria:
Patient/child eligibility criteria:
Inclusion Criteria:
- Age 2-17 years
- Primary diagnosis of asthma
Exclusion Criteria:
- Transferred in from another inpatient facility
- Presence of a chronic medical condition that precludes pathway use
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