Leveraging Electronic Health Record Tools to Improve the Evidence-Based Treatment of Children Hospitalized With Bronchiolitis

Overview

The goal of this experimental study is to learn whether different types of best practice advisories (BPAs) that direct clinicians to reference clinical guidelines embedded in the electronic health record (EHR) increase the delivery of evidence-based care in children presenting to the hospital with bronchiolitis. The main questions it aims to answer are: * Do BPAs improve clinicians' delivery of guideline-concordant care in bronchiolitis? * Do interruptive BPAs improve guideline-concordant care of bronchiolitis more than non-interruptive BPAs? Researchers will compare the treatment and outcomes of patients whose clinicians did not receive a BPA, to those whose clinicians received a non-interruptive BPA, to those whose clinicians received an interruptive BPA. Patients will continue to receive standard hospital care for bronchiolitis. Clinicians will: * retain access to an EHR-embedded clinical guideline for bronchiolitis care * be exposed to either no BPA, a non-interruptive BPA, or an interruptive BPA promoting the EHR-embedded clinical guideline (randomized per patient encounter)

Bronchiolitis, a viral respiratory illness affecting infants and toddlers, is the most common reason children less than 2 years old are hospitalized. However, many children admitted with bronchiolitis receive unnecessary treatments that do not hasten recovery and may even cause harm. Despite evidence that the best treatment for bronchiolitis is supportive care (i.e. oxygen and hydration support), clinicians continue to overuse certain therapies, leading to longer hospital stays, higher costs, and increased stress for families. The investigators will study the effects of BPAs, which are real-time alerts within the EHR. The BPAs in this study promote the use of an evidence-based care guideline for bronchiolitis that is embedded within the EHR. There are multiple BPA designs commonly used in EHRs: 1) interruptive BPAs, which require clinicians to interact with the alert to continue the clinician's workflow; and 2) non-interruptive BPAs, which appear as visual cues but do not require clinicians to alter workflows.