Choosing Wisely for Bronchiolitis – Comparative Provider Feedback Pareto Analysis

Tool:
Comparative Provider Feedback Pareto Analysis

Problem:
The aim of this quality improvement project is to de-implement the utilization of potentially unnecessary interventions, and thus provide high-value care for children ages 2 months through 2 years with bronchiolitis presenting in the emergency department and inpatient units.

Tool Selection:
De-implementation of longstanding practice to meet evolving evidence-based standards is challenging. Education, decision support tools, and visual aids, can be helpful to overcome barriers to change, but early results were stagnant. Experience informed us that comparative provider performance analysis of evidence based care is often an effective change strategy

Usage:
We amassed a large body of data. The providers were unaware of their own performance. Using a provider performance column chart sorted in Pareto format, we devised an innovative method to email merge a letter to each provider with their individual masked letter code and the comparative pareto chart.

Results:
Initially we struggled to achieve improvement. Often a successful change package is to provide physician feedback. Following two iterations of individualized provider feedback, a sustained shift occurred in the median bundle performance from a persistent 36% median to 52%, achieving our goal in the autumn of 2021.

Speakers
Resident Physician
Resident Physician – Atrium Health Levine Children's Hospital

Speaker Type: HQ Best Practice Tools On-Demand

  • Performance and Process Improvement IconPerformance and Process Improvement
Resident Physician
Resident Physician – Atrium Health Levine Children's Hospital

Speaker Type: HQ Best Practice Tools On-Demand

  • Performance and Process Improvement IconPerformance and Process Improvement
Outcomes Specialist
Outcomes Specialist – Atrium Health Levine Children's Hospital

Speaker Type: HQ Best Practice Tools On-Demand

  • Performance and Process Improvement IconPerformance and Process Improvement
Event Details