A clinical pathway for bronchiolitis is effective in reducing readmission rates.
OBJECTIVE
To examine the use of a clinical pathway in the management of infants hospitalized with acute viral bronchiolitis.


METHODS
A clinical pathway with specific management and discharge criteria for the care of infants with bronchiolitis was developed from pathways used in tertiary care pediatric institutions in Australia. Two hundred and twenty-nine infants admitted to hospital with acute viral bronchiolitis and prospectively managed using a pathway protocol were compared with a retrospective analysis of 207 infants managed without a pathway in 3 regional and 1 tertiary care hospital.


RESULTS
Readmission to hospital was significantly lower in the pathway group (P = .001), as was administration of supplemental fluids (P = .001) and use of steroids (P = .005). There were no differences between groups in demographic factors or clinical severity. The pathway had no overall effect on length of stay or time in oxygen.


CONCLUSIONS
A clinical pathway specifying local practice guidelines and discharge criteria can reduce the risk of readmission to hospital, the use of inappropriate therapies, and help with discharge planning.
Cheney
Joyce
J
Department of Respiratory Medicine, Royal Children's Hospital, the School of Nursing, Queensland University of Technology, Australia. Joyce_Cheney@health.qld.gov.au
Barber
Scott
S
Altamirano
Luis
L
Medico Cirujano
Cheney
Marise
M
Williams
Chris
C
Jackson
Mary
M
Yates
Patsy
P
O'Rourke
Peter
P
Wainwright
Claire
C
D000208:Acute Disease; D000704:Analysis of Variance; D001990:Bronchiolitis, Viral / Q000628:therapy*; D019091:Critical Pathways; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000592:standards* / Q000706:statistics & numerical data; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011793:Queensland; D012189:Retrospective Studies; D012307:Risk Factors