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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
2,700
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.
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.
Children's of Alabama
Birmingham, Alabama, United States
RECRUITINGPhoenix Children's Hospital - Arrowhead Campus
Glendale, Arizona, United States
RECRUITINGPhoenix Children's Hospital
Phoenix, Arizona, United States
RECRUITINGAdventist Health Lodi Memorial
Lodi, California, United States
Adoption
Proportion of participants who are prescribed PRN follow-up
Time frame: Within 7 days of hospital discharge
Sustainment
Proportion of participants who attend a follow-up visit
Time frame: Within 7 days of hospital discharge
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Children's Hospital Los Angeles
Los Angeles, California, United States
RECRUITINGUCLA Mattel Children's Hospital
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RECRUITINGValley Children's Hospital
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RECRUITINGChildren's Hospital Orange County (CHOC)
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RECRUITINGUniversity of California Davis Children's Hospital
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RECRUITINGChildren's Hospital Colorado
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RECRUITING...and 52 more locations