An evidence-based practice change was implemented in six weeks of project launch and sustained for seven months.
Acute gastroenteritis (AGE) affects a third of children under age 3 who are unvaccinated or infected with other viruses. To treat the severe diarrhea, patients historically receive just oral rehydration. Despite evidence that probiotics such as Lactobacillus rhamonosus GG (LGG) reduce the duration of diarrhea, few patients (1%) admitted to the hospital are routinely prescribed it.
Investigators at the Cincinnati Children’s Hospital Medical Center wanted to quickly increase the percentage of children with AGE who are given LCC to 90 percent within 120 days.
To do that, they engaged a multidisciplinary team that included physicians, nurses, and a quality improvement coach, as well as representatives of the evidence-based guideline development group to apply the Rapid Cycle Improvement Collaborative method. The team mapped processes, identified key drivers of LGG use, and developed interventions to promote LGG use. They educated key stakeholders and also made sure that adequate doses of LGG were available in hospital locations. Further, they updated the existing gastroenteritis order set in the electronic medical record.
As a result of their efforts, prescription of LGG at admission for children with AGE increased to 100 percent within six weeks of the project’s beginning. That rate of prescribing has been sustained for seven months.
- 1. Well-Child Care Clinical Practice Redesign for Young Children
- 2. Reducing Quality of Care Disparities in Childhood Asthma
- 3. National Quality Measures for Child Mental Health Care
- 4. Do Parent Perceptions Predict Continuity of Publicly Funded Care for Attention-Deficit/Hyperactivity Disorder?
- 5. Systematic Update of Computerized Physician Order Entry Order Sets to Improve Quality of Care
- 6. Methods of Mortality Risk Adjustment in the NICU
- 7. Accuracy of Hospital Administrative Data in Reporting Central Line-Associated Bloodstream Infections in Newborns
- 8. Variation in Surgical Outcomes for Adolescents and Young Adults with Inflammatory Bowel Disease
- 9. The Factors Associated with High-Quality Communication for Critically Ill Children
- 10. Rapid Adoption of Lactobacillus rhamnosus GG for Acute Gastroenteritis
- 11. Management of Bronchiolitis in the Emergency Department
- 12. Assessing Quality Improvement in Health Care
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