Evidence map›Paper›PMID 34382224›Full record

ArticleHealth services research2022

Strategies for sustaining high-quality pediatric asthma care in community hospitals.

Sravya Jaladanki, Sarah B Schechter, Marquita C Genies, Michael D Cabana, Roberta S Rehm, Eric Howell, Sunitha V Kaiser

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In one paragraph

Article in Health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sravya JaladankiDepartment of Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Sarah B SchechterDepartment of Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Marquita C GeniesDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Michael D CabanaDepartment of Pediatrics, Albert Einstein College of Medicine, New York, New York, USA.
Roberta S RehmDepartment of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA.
Eric HowellSociety of Hospital Medicine, Philadelphia, Pennsylvania, USA.
Sunitha V KaiserDepartments of Pediatrics, Epidemiology and Biostatistics, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-9862-9362

Funding

The SHAKE Study: Sustaining High-quality Asthma care for Kids EverywhereR03HS027041 · AHRQ · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KAISER, SUNITHA VEMULA · 2020 to 2021
$99k
AHRQ HHS R03 HS027041
6 · The paper itself

Abstract

objectiveTo identify strategies associated with sustained guideline adherence and high-quality pediatric asthma care in community hospitals. DATA SOURCES: Primary qualitative data from clinicians in hospitals across the United States (collected December 2019-February 2021). STUDY

designPathways for Improving Pediatric Asthma Care (PIPA) was a national quality improvement (QI) intervention. In a prior quantitative study, data from 23 community hospitals in PIPA were analyzed to identify sites with the highest and lowest performance in sustaining improvements for 2 years. In this qualitative study, we conducted semi-structured interviews with multidisciplinary clinicians from these hospitals to identify strategies associated with sustainability. DATA COLLECTION/EXTRACTION

methodsWe purposefully sampled and interviewed participants involved in clinical care of children hospitalized with asthma at the identified hospitals (those with the highest/lowest sustainability performance). We transcribed and analyzed interview data using constant comparative methods. PRINCIPAL

findingsClinicians (n = 19) from five higher- and three lower-performing hospitals participated. In higher-performing hospitals, dedicated local champions more consistently provided reminders of evidence-based practices and delivered ongoing education. They also modified/developed electronic health record (EHR) tools (e.g., order sets with decision support). Higher-performing hospitals had a collaborative culture receptive to practice change and set firm expectations that evidence-based practices would be followed without exception. In lower-performing hospitals, participants described unique barriers, including delays in modifying the EHR and lack of automation of EHR tools (requiring clinicians to remember new EHR tasks without automated prompts). Barriers to sustainability for all hospitals included challenges with quality monitoring, decreasing focus of local champions over time, and ongoing difficulties developing consensus around evidence-based practices.

conclusionsTo better ensure sustained high-quality care for children with asthma and greater returns on QI investments, QI leaders should prioritize: designating long-term local champions to continue reminders and educational efforts and developing electronic order sets to provide ongoing decision support.

Indexed as

AsthmaChildCritical PathwaysHealth Plan ImplementationHospitals, CommunityHospitals, PediatricHumansQuality ImprovementQuality of Health CareUnited Statesasthmachildhospitalsprogram evaluationquality improvement

Identifiers

PMID34382224
PMCPMC8763281

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.