• Jennifer A Faerber, Rui Xiao, Spandana Makeneni, Enrique F Schisterman, Patrick W Brady, Amanda C Schondelmeyer, Christopher P Landrigan, Kate Lucey, Vivian Lee, Polina F Gregory, Julianne Prasto, Padmavathy Parthasarathy, Morgan Greenfield, Courtney Solomon, Canita R Brent, Kimberly Albanowski, Rinad S Beidas, Christopher P Bonafide, and Pediatric Research in Inpatient Settings (PRIS) Network.
• Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
• J Hosp Med. 2023 Aug 1; 18 (8): 724729724-729.

AbstractUsing continuous pulse oximetry (cSpO2 ) to monitor children with bronchiolitis who are not receiving supplemental oxygen is a form of medical overuse. In this longitudinal analysis from the Eliminating Monitor Overuse (EMO) study, we aimed to assess changes in cSpO2 overuse before, during, and after intensive cSpO2 -deimplementation efforts in six hospitals. Monitoring data were collected during three phases: "P1" baseline, "P2" active deimplementation (all sites engaged in education and audit and feedback strategies), and "P3" sustainment (a new baseline measured after strategies were withdrawn). Two thousand and fifty-three observations were analyzed. We found that each hospital experienced reductions during active deimplementation (P2), with overall adjusted cSpO2 overuse decreasing from 53%, 95% confidence interval (CI): (49-57) to 22%, 95% CI: (19-25) between P1 and P2. However, following the withdrawal of deimplementation strategies, overuse rebounded in all six sites, with overall adjusted cSpO2 overuse increasing to 37%, 95% CI: (33-41) in P3.© 2023 Society of Hospital Medicine.

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