Bronchiolitis, Evidence-Based Medicine, Pulmonology

Does Adhering to a Bronchiolitis Clinical Pathway Make a Difference?by Dr Lewis First MD, MA, Editor in Chief, Pediatrics

We're in the midst of bronchiolitis season right now, which canfill hospital beds, and depending on the treatments administered and duration of stay, can raise issues of cost-effectiveness of a hospitalization for this illness. That is why clinical pathways based on best-evidence havebeen devised. These can increase the value and cost-effectiveness of the care we administer to young infants. So how closely do we tend to adhere to these clinical pathway guidelines and when we do, does it make adifference?  Bryan et al. ( 10.1542/peds.2016-3432)  share with us this week a retrospective cohort studyinvolving more than 250 patients ages 0-24 months who were diagnosed with bronchiolitis and measured foradherence to a clinical pathway as well as for length of stay and cost of care in the ED and on an inpatientservice.  The results are quite striking and show significant differences in decreased length of stay withincreased adherence to a bronchiolitis care pathway.  Cost was also reduced with increased adherence.  So areyou using a care pathway for your sickest patients with bronchiolitis requiring ED or inpatient care?  Do you thinkit has reduced length of stay and cost for your patients?  We would love to know what guideline you are using orthinking of using after reading this study by sharing with us a response to this blog, or by posting a comment onour Facebook or Twitter sites or better yet-a comment on our website where this article appears.

Facebook●

Instagram●

The Fecal Microbiota Profile and Bronchiolitis in Infants●

Copyright © 2017 American Academy of Pediatrics