1. CHAT Bronchiolitis Key Driver Diagram
AIM (S)
KEY DRIVERS (WHAT)
CHANGE STRATEGIES (HOW)
Decrease the over utilization of resources (tests, non-evidence based therapies, LOS, readmissions) for patients with bronchiolitis of 10% by July 2018
*goal to be confirmed with baseline data analysis
Prevention: These strategies will
focus on preventing the spread
and contraction of bronchiolitis.
Change Strategies 1-3
Appropriate hand hygiene
Inquire about smoke exposure and counsel about cessation if positive for smoke exposure
Educate hospital personnel, community clinicians, and families about evidence-based diagnosis, treatment and prevention of bronchiolitis
Diagnose bronchiolitis and assess severity based on History and Physical Exam
Recommend to not obtain for diagnosis of bronchiolitis
CXR
Laboratory studies
Recommend to not use
Steroids
Antibiotics
Albuterol
Epinephrine (inpatients)
Hypertonic saline (ED)
CPT
Recommended to not use O² if SPO² >90%
Consider NOT using continuous pulse ox
USE NG or IVF to hydrate patients that can’t hydrate themselves.
Use a standardized protocol for starting High Flow
Use a standardized oxygen weaning protocol
Diagnosis: These strategies will
decrease unnecessary testing for
patients diagnosed with
bronchiolitis
Change Strategies 4-5
Treatment: These strategies will
Decrease unnecessary
Interventions and therapies used
to treat bronchiolitis.
Change Strategies 6-11