Rising utilization of inpatient pediatric asthma pathways

Sunitha V. Kaiser, Jonathan Rodean, Arpi Bekmezian, Matt Hall, Samir S. Shah, Sanjay Mahant, Kavita Parikh, Rustin Morse, Henry Puls, Michael D. Cabana

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Clinical pathways are detailed care plans that operationalize evidence-based guidelines into an accessible format for health providers. Their goal is to link evidence to practice to optimize patient outcomes and delivery efficiency. It is unknown to what extent inpatient pediatric asthma pathways are being utilized nationally. Objectives: (1) Describe inpatient pediatric asthma pathway design and implementation across a large hospital network. (2) Compare characteristics of hospitals with and without pathways. Methods: We conducted a descriptive, cross-sectional, survey study of hospitals in the Pediatric Research in Inpatient Settings Network (75% children's hospitals, 25% community hospitals). Our survey determined if each hospital used a pathway and pathway characteristics (e.g. pathway elements, implementation methods). Hospitals with and without pathways were compared using Chi-square tests (categorical variables) and Student's t-tests (continuous variables). Results: Surveys were distributed to 3–5 potential participants from each hospital and 302 (74%) participants responded, representing 86% (106/123) of surveyed hospitals. From 2005–2015, the proportion of hospitals utilizing inpatient asthma pathways increased from 27% to 86%. We found variation in pathway elements, implementation strategies, electronic medical record integration, and compliance monitoring across hospitals. Hospitals with pathways had larger inpatient pediatric programs [mean 12.1 versus 6.1 full-time equivalents, p = 0.04] and were more commonly free-standing children's hospitals (52% versus 23%, p = 0.05). Conclusions: From 2005–2015, there was a dramatic rise in implementation of inpatient pediatric asthma pathways. We found variation in many aspects of pathway design and implementation. Future studies should determine optimal implementation strategies to better support hospital-level efforts in improving pediatric asthma care and outcomes.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalJournal of Asthma
DOIs
StateAccepted/In press - May 18 2017

Fingerprint

Inpatients
Asthma
Pediatrics
Cross-Sectional Studies
Pediatric Hospitals
Critical Pathways
Electronic Health Records
Community Hospital
Chi-Square Distribution
Compliance
Guidelines
Students
Health

Keywords

  • Children
  • clinical pathways
  • hospital
  • implementation
  • quality improvement

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Kaiser, S. V., Rodean, J., Bekmezian, A., Hall, M., Shah, S. S., Mahant, S., ... Cabana, M. D. (Accepted/In press). Rising utilization of inpatient pediatric asthma pathways. Journal of Asthma, 1-12. https://doi.org/10.1080/02770903.2017.1316392

Rising utilization of inpatient pediatric asthma pathways. / Kaiser, Sunitha V.; Rodean, Jonathan; Bekmezian, Arpi; Hall, Matt; Shah, Samir S.; Mahant, Sanjay; Parikh, Kavita; Morse, Rustin; Puls, Henry; Cabana, Michael D.

In: Journal of Asthma, 18.05.2017, p. 1-12.

Research output: Contribution to journalArticle

Kaiser, SV, Rodean, J, Bekmezian, A, Hall, M, Shah, SS, Mahant, S, Parikh, K, Morse, R, Puls, H & Cabana, MD 2017, 'Rising utilization of inpatient pediatric asthma pathways', Journal of Asthma, pp. 1-12. https://doi.org/10.1080/02770903.2017.1316392
Kaiser SV, Rodean J, Bekmezian A, Hall M, Shah SS, Mahant S et al. Rising utilization of inpatient pediatric asthma pathways. Journal of Asthma. 2017 May 18;1-12. https://doi.org/10.1080/02770903.2017.1316392
Kaiser, Sunitha V. ; Rodean, Jonathan ; Bekmezian, Arpi ; Hall, Matt ; Shah, Samir S. ; Mahant, Sanjay ; Parikh, Kavita ; Morse, Rustin ; Puls, Henry ; Cabana, Michael D. / Rising utilization of inpatient pediatric asthma pathways. In: Journal of Asthma. 2017 ; pp. 1-12.
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