TABLE 1

Characteristics of Studies of QI Strategies for Bronchiolitis

Author, YearStudy DesignDurationSettingPatient PopulationInterventionTarget of Intervention
Educational interventions/guidelines/pathways
 Adcock et al,25 1998Before-and-after study1 winter seasonKosair Children’s Hospital, Louisville, KY153Guideline (1 page) and educational programPhysicians
 Harrison et al,28 2001Interrupted time series before-and-after study 2 winter seasonsUpstate Medical University Syracuse, NY171Guideline (1 page) and educational programPhysicians, nurses, respiratory therapists
  Wilson et al,30 2002Matched case/control1 seasonChildren’s Hospital of Central California Fresno, CA181Bronchiolitis pathway (summary educational information and parent education materials)Physicians
 Cheney et al,34 2005Cohort study with historical control subjectsMay 1998–August 1999 vs May 2000 –August 2001Four hospitals in Australia (1 tertiary children’s facility and 3 regional hospitals)436Clinical pathway, nursing focusedNurses, physicians
 King et al,35 2007Interrupted time series before-and-after study2 winter seasonsChildren’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada316Clinical evidence module within physician computerized order entry systemPhysicians
 Black and Brennan,36 2011Interrupted time series before-and-after study2 winter seasonsCentral Dupage Hospital, Winfield, IL88Protocol and order set. Educational programNurses, respiratory therapists, physicians
 Walker et al,37 2012Interrupted time series before-and-after study7 winter seasons, 2 before, 5 afterRoyal Aberdeen Children’s Hospital, Scotland328Clinical pathway, extensive multidisciplinary involvementPhysicians, nurses
Forcing function
  Perlstein et al,26 1999Interrupted time series before-and-after study 5 winter seasons, 4 before, 1 afterChildren’s Hospital Medical Center, Cincinnati, OH1529Extensive clinical practice guideline, including order set and respiratory scorePhysicians, nurses, respiratory therapists
  Perlstein et al,27 2000Interrupted time series before-and-after study6 winter seasons, 4 before and 2 after (overlaps with above)Children’s Hospital Medical Center, Cincinnati, OH1979 (overlaps with Perlstein 1999)Extensive clinical practice guideline, including order set and respiratory scorePhysicians, nurses, respiratory therapists
  Kotagal et al,31 2002Interrupted time series before-and-after study 2 winter seasonsSeven children’s hospitals in the Child Health Accountability Initiative1139Clinical practice guideline as published by CCHMC above (local modifications allowed at each site)Physicians, nurses, respiratory therapists
 Todd et al,29 2002Interrupted time series before-and-after study with additional external control subjects4 winter seasons (data for 2 seasons available for this analysis)Children’s Hospital Denver, CO (with PHIS database as external controls)570 (Denver cohort only)Clinical practice guideline, respiratory scorePhysicians
  Simpson et al,32 2003Interrupted time series before-and-after study 3 winter seasons, 1 before and 2 afterChildren’s Hospital of Arkansas, Little Rock, AR415 (included in Kotagal et al)Clinical practice guideline as published by CCHMC (Perlstein)Physicians
  Muething et al33, 2004Interrupted time series before-and-after study 6 winter seasons, 5 before, 1 after (3 used in this analysis)Children’s Hospital Medical Center, Cincinnati, OH1528 (overlaps with Perlstein et al 1999 and 2000)Point-of-care algorithm, order set, respiratory score, and pathwayPhysicians, respiratory therapists, families
 Mittal et al,38 2014Interrupted time series before-and-after study 3 winter seasons, 1 before, 2 afterChildren’s Medical Center, Dallas, TX3686Clinical practice guideline integrated into electronic order sets, respiratory score, educational campaignPhysicians, nurses, respiratory therapists
  • CCHMC, Cincinnati Children’s Hospital Medical Center.