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- W4289270147 abstract "Introduction: Our emergency department updated our care algorithm to provide evidence-based, standardized care to 0- to 60-day-old febrile neonates. Specifically, we wanted to increase the proportion of visits for which algorithm-adherent care was provided from 90% to 95% for infants 0–28 days, and from 67% to 95% for infants 29–60 days, by June 30, 2020. Methods: Our emergency medicine team outlined our theory for improvement and used multiple plan-do-study-act cycles to test interventions aimed at key drivers. Interventions included constructing an updated care algorithm, clinician, and nurse education, integrating an updated opt-out order set, and streamlined discharge instructions. Our primary outcome was the proportion of patient encounters in which clinicians ordered algorithm-adherent care. In addition, our quality improvement team manually reviewed all failures to determine the reasons for failure and inform further interventions. Results: We evaluated 2,248 visits between January 2018 and October 2021. Algorithm-adherent care for 29- to 60-day-old infants improved from 67% to 92%. Algorithm-adherent care for 0- to 28-day infants improved from 90% to 96%. We sustained these improvements for 22 months. Failure to adhere to the algorithm in the 29- to 60-day-old infant group was primarily due to clinicians not ordering procalcitonin. Conclusions: Using quality improvement methods, we successfully increased algorithm-adherent evaluation of febrile neonates 0–60 days old in our pediatric emergency departments. Education and opt-out order sets were keys to implementing our new algorithm." @default.
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- W4289270147 date "2022-07-01" @default.
- W4289270147 modified "2023-09-25" @default.
- W4289270147 title "Improving the Evidence-based Care of Febrile Neonates: A Quality Improvement Initiative" @default.
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- W4289270147 doi "https://doi.org/10.1097/pq9.0000000000000583" @default.
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