Susan C Walley1, Grant M Mussman2, Michele Lossius3, Kristin A Shadman4, Lauren Destino5, Matthew Garber6, Shawn L Ralston7. 1. Department of Pediatrics, University of Alabama at Birmingham and Children's of Alabama, Birmingham, Alabama; swalley@peds.uab.edu. 2. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 3. University of Florida Health Shands Children's Hospital, University of Florida, Gainesville, Florida. 4. Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin. 5. Lucile Packard Children's Hospital, School of Medicine, Stanford University, Palo Alto, California. 6. Wolfson Children's Hospital, University of Florida, Jacksonville, Florida; and. 7. Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.
Abstract
BACKGROUND AND OBJECTIVES: We sought to implement systematic tobacco dependence interventions for parents and/or caregivers as secondary aims within 2 multisite quality improvement (QI) collaboratives for bronchiolitis. We hypothesized that iterative improvements in tobacco dependence intervention strategies would result in improvement in outcomes between collaboratives. METHODS: This study involved 2 separate yearlong, multisite QI collaboratives that were focused on care provided to inpatients with a primary diagnosis of bronchiolitis. In each collaborative, we provided tools and training in tobacco dependence treatment and expert coaching on interventions for parents as a secondary aim. Data were collected by chart review and results analyzed by using analysis of means and statistical process control analysis. Outcomes between collaboratives were compared by using relative risks. RESULTS: Between both collaboratives, 56 hospitals participated and 6258 inpatient charts were reviewed. In the first collaborative, 22% of identified parents who smoke received tobacco dependence interventions at baseline. This rate increased to 51% during the postintervention period, with special cause revealed by analysis of means. In the second collaborative, 31% of parents who smoke received baseline interventions. This rate increased to 53% by the conclusion of the collaborative, with special cause revealed by statistical process control analysis. The relative risk for providing any cessation intervention in 1 collaborative versus the other was 0.9 (confidence interval 0.8-1.1). CONCLUSIONS: Tobacco dependence treatment of parents and/or caregivers can be integrated into bronchiolitis QI by using relatively low-resource strategies. Using a more intensive QI intervention did not alter the rates of screening or intervention for caregivers who smoke.
BACKGROUND AND OBJECTIVES: We sought to implement systematic tobacco dependence interventions for parents and/or caregivers as secondary aims within 2 multisite quality improvement (QI) collaboratives for bronchiolitis. We hypothesized that iterative improvements in tobacco dependence intervention strategies would result in improvement in outcomes between collaboratives. METHODS: This study involved 2 separate yearlong, multisite QI collaboratives that were focused on care provided to inpatients with a primary diagnosis of bronchiolitis. In each collaborative, we provided tools and training in tobacco dependence treatment and expert coaching on interventions for parents as a secondary aim. Data were collected by chart review and results analyzed by using analysis of means and statistical process control analysis. Outcomes between collaboratives were compared by using relative risks. RESULTS: Between both collaboratives, 56 hospitals participated and 6258 inpatient charts were reviewed. In the first collaborative, 22% of identified parents who smoke received tobacco dependence interventions at baseline. This rate increased to 51% during the postintervention period, with special cause revealed by analysis of means. In the second collaborative, 31% of parents who smoke received baseline interventions. This rate increased to 53% by the conclusion of the collaborative, with special cause revealed by statistical process control analysis. The relative risk for providing any cessation intervention in 1 collaborative versus the other was 0.9 (confidence interval 0.8-1.1). CONCLUSIONS:Tobacco dependence treatment of parents and/or caregivers can be integrated into bronchiolitis QI by using relatively low-resource strategies. Using a more intensive QI intervention did not alter the rates of screening or intervention for caregivers who smoke.
Authors: Karen M Wilson; Angela Moss; Michelle Lowary; Jacqueline Holstein; Jessica Gambino; Elizabeth Juarez-Colunga; Gwendolyn S Kerby; Jonathan D Klein; Melbourne Hovell; Jonathan P Winickoff Journal: Acad Pediatr Date: 2021-11-21 Impact factor: 2.993
Authors: Karen M Wilson; Angela Moss; Michelle Lowary; Jessica Gambino; Jonathan D Klein; Gwendolyn S Kerby; Melbourne Hovell; Jonathan P Winickoff Journal: Hosp Pediatr Date: 2020-12-03