REST EEC: Respiratory Support and Treatment for Efficient and Cost-Effective Care
Study Details
Study Description
Brief Summary
This project aims to answer the essential questions about the management of acute, pediatric respiratory illness, accelerate recovery from these all-too-common diseases, curb unnecessary costs of care, and demonstrate UPMC Children's Hospital of Pittsburgh's capabilities as the premier, world-class leader in the arena of pediatric learning healthcare systems. REST EEC will focus on the question of whether clinical decision support (CDS) facilitates the standardization of the initiation and weaning of heated high flow nasal cannula (HHFNC) for bronchiolitis.REST EEC will focus on whether the application of CDS improves adherence to a standardized guideline and leads to improved patient-centered outcomes.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: HHFNC + Clinical decision Support Standardized HHFNC weaning coupled with clinical decision support consisting of electronic record embedded reminders to the clinical team to wean HHFNC |
Other: Clinical Decision Support (CDS)
Education to front line clinicians and staff on standardized implementation and weaning of HHFNC and standardized assessments of patient work of breathing. HHFNC implementation and weaning strategies will be based on age-specific practices recommended by the American Academy of Pediatrics. Education will be undertaken by dedicated clinical educators.
Device: HHFNC Weaning
Wean patient off oxygen and flow as oxygenation and work of breathing improves.
|
| Active Comparator: HHFNC Weaning Team does not receive clinical decision support reminders to wean the HHFNC |
Other: Clinical Decision Support (CDS)
Education to front line clinicians and staff on standardized implementation and weaning of HHFNC and standardized assessments of patient work of breathing. HHFNC implementation and weaning strategies will be based on age-specific practices recommended by the American Academy of Pediatrics. Education will be undertaken by dedicated clinical educators.
Device: HHFNC Weaning
Wean patient off oxygen and flow as oxygenation and work of breathing improves.
|
Outcome Measures
Primary Outcome Measures
- ICU length of stay [From date admitted into ICU until the date of discharge from ICU or death from any cause, assessed up to 90 days]
Days in ICU
Secondary Outcome Measures
- Respiratory support free days [Days from start of respiratory support to respiratory support free day]
Days alive and free of intensive care unit-based respiratory
- Hospital length of stay [Days from admission to discharge from hospital or death]
Days admitted in hospital
- Organ support free days [Days from admission to organ support free days]
Days alive and free of ICU-based respiratory or cardiovascular organ support
- Time to oral intake [Days from being off HFNC until oral intake]
Time from HHFNC and oral intake
- Ostensible respiratory distress measured by a respiratory severity score [Through study completion, an average of 1 week]
The product of mean airway pressure and the fraction of inspired oxygen
- Cost of hospitalization [Days from admission to discharge from hospital or date of death, up to 90 days]
Totality of expenses incurred by a hospital in providing its services and care
- 90-day cost of care [Days of care from admission to 90 days]
Total cost is your premium + deductible + out-of-pocket costs + any total resource use and unit price(s), by payer or consumer, for a healthcare service or group of healthcare services, associated with a specified patient populationâ‘ , time period, and unit(s) of clinical accountability for 90 days
- Mortality [Days from admission to death]
Patient Death
Eligibility Criteria
Criteria
Inclusion Criteria:
- <2 years of age Bronchiolitis WOB Score >2
Exclusion Criteria:
-
Immunocompromised
-
Immunosuppressed
-
Chronic lung disease
-
Congenital heart disease with baseline cardiorespiratory manifestations
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | UPMC Children's Hospital of Pittsburgh | Pittsburgh | Pennsylvania | United States | 15224 |
Sponsors and Collaborators
- University of Pittsburgh
- Beckwith Foundation
Investigators
- Principal Investigator: Christopher Horvat, MD, UPMC Children's Hospital of Pittsburgh
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- STUDY23010030