Implementation of Febrile Infant Management Guidelines Reduces Hospitalization

Overview

Journal Pediatr Qual Saf

Date 2020 Mar 20

PMID 32190797

Citations 6

Authors

Lauren Z Foster

Joshua Beiner

Carol Duh-Leong

Kira Mascho

Victoria Giordani

Michael L Rinke

Leonardo Trasande

Ethan Wiener

Rebecca E Rosenberg

Affiliations

Soon will be listed here.

Abstract

Methods: The Model for Improvement was used to implement a CPG for the management of well-appearing febrile infants, with collaboration between pediatric emergency medicine and pediatric hospital medicine physicians. Interventions included physician education, process audit/feedback, and development of an electronic orderset. We used statistical process control charts to assess the primary aims of appropriate risk stratification and length of stay.

Results: Over a 34-month period, 168 unique encounters (baseline n = 65, intervention n = 103) were included. There was strong adherence for appropriate risk stratification in both periods: the proportion of low-risk patients admitted inappropriately decreased from 14.8% to 10.8%. Among admitted high-risk patients, the mean length of stay decreased from 49.4 to 38.2 hours, sustained for 18 months.

Conclusion: CPG implementation using quality improvement methodology can increase the delivery of evidence-based care for febrile infants, leading to a reduction in length of stay for high-risk infants.

Citing Articles

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A quality improvement approach to improving care of febrile infants.

Gupta J, Zipursky A, Pirie J, Freire G, Karin A, Bohn M Paediatr Child Health. 2024; 29(3):135-143.

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Orfanos I, Lindkvist R, Eklund E, Elfving K, Alfven T, De Koning T BMC Pediatr. 2024; 24(1):81.

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Febrile infants risk score at triage (FIRST) for the early identification of serious bacterial infections.

Chong S, Niu C, Ong G, Piragasam R, Khoo Z, Koh Z Sci Rep. 2023; 13(1):15845.

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