Decreasing Exposure to Radiation, Surgical Risk, and Costs for Pediatric Complicated Pneumonia: A Guideline Evaluation

Rachel D. Quick, Michael J. Auth, Marisol Fernandez, Tory Meyer, Kathryn G. Merkel, Lynn M. Thoreson, Sarmistha B. Hauger

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVES: This report describes the creation and successful implementation of a complicated pneumonia care algorithm at our institution. Outcomes are measured for specific goals of the algorithm: to decrease radiation exposure, surgical risk, and patient charges without adversely affecting clinical outcomes.

METHODS: We describe steps involved in algorithm creation and implementation at our institution. To depict outcomes of the algorithm, we completed a retrospective cohort study of hospitalized pediatric patients with a diagnosis of complicated pneumonia at a single institution between January 2010 and April 2016 who met criteria for the algorithm. Charts were manually reviewed and data were analyzed via Wilcoxon rank sum, χ2, and Fisher's exact tests.

RESULTS: Throughout the algorithm creation process, our institution began to see a change in practice. We saw a statistically significant decrease in the number of patients who underwent a chest computed tomography scan and an increase in patients who underwent a chest ultrasound (P < .001). We also saw an increase in the use of chest tube placement with fibrinolytics and a decrease in the use of video-assisted thoracoscopic surgery as the initial chest procedure (P ≤ .001) after algorithm implementation. These interventions reduced related charges without significantly affecting length of stay, readmission rate, or other variables studied.

CONCLUSIONS: The collaborative creation and introduction of an algorithm for the management of complicated pneumonia at our institution, combined with an effort among physicians to incorporate evidence-based clinical care into practice, led to reduced radiation exposure, surgical risk, and cost to patient.

Original languageEnglish (US)
Pages (from-to)287-293
Number of pages7
JournalHospital pediatrics
Volume7
Issue number5
DOIs
StatePublished - May 1 2017

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Pneumonia
Guidelines
Pediatrics
Costs and Cost Analysis
Thorax
Video-Assisted Thoracic Surgery
Chest Tubes
Radiation Exposure
Length of Stay
Cohort Studies
Retrospective Studies
Tomography
Physicians

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Quick, R. D., Auth, M. J., Fernandez, M., Meyer, T., Merkel, K. G., Thoreson, L. M., & Hauger, S. B. (2017). Decreasing Exposure to Radiation, Surgical Risk, and Costs for Pediatric Complicated Pneumonia: A Guideline Evaluation. Hospital pediatrics, 7(5), 287-293. https://doi.org/10.1542/hpeds.2016-0077

Decreasing Exposure to Radiation, Surgical Risk, and Costs for Pediatric Complicated Pneumonia : A Guideline Evaluation. / Quick, Rachel D.; Auth, Michael J.; Fernandez, Marisol; Meyer, Tory; Merkel, Kathryn G.; Thoreson, Lynn M.; Hauger, Sarmistha B.

In: Hospital pediatrics, Vol. 7, No. 5, 01.05.2017, p. 287-293.

Research output: Contribution to journalArticle

Quick, RD, Auth, MJ, Fernandez, M, Meyer, T, Merkel, KG, Thoreson, LM & Hauger, SB 2017, 'Decreasing Exposure to Radiation, Surgical Risk, and Costs for Pediatric Complicated Pneumonia: A Guideline Evaluation', Hospital pediatrics, vol. 7, no. 5, pp. 287-293. https://doi.org/10.1542/hpeds.2016-0077
Quick, Rachel D. ; Auth, Michael J. ; Fernandez, Marisol ; Meyer, Tory ; Merkel, Kathryn G. ; Thoreson, Lynn M. ; Hauger, Sarmistha B. / Decreasing Exposure to Radiation, Surgical Risk, and Costs for Pediatric Complicated Pneumonia : A Guideline Evaluation. In: Hospital pediatrics. 2017 ; Vol. 7, No. 5. pp. 287-293.
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