Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Multicenter Study
Barriers and Facilitators to Guideline-Adherent Pulse Oximetry Use in Bronchiolitis.
Continuous pulse oximetry monitoring (cSpO2) in children with bronchiolitis does not improve clinical outcomes and has been associated with increased resource use and alarm fatigue. It is critical to understand the factors that contribute to cSpO2 overuse in order to reduce overuse and its associated harms. ⋯ We identified barriers and facilitators to deimplementation of cSpO2 for stable patients with bronchiolitis across children's hospitals with high- and low-cSpO2 use. Based on these data, future deimplementation efforts should focus on clear protocols for cSpO2, EHR changes, and education for hospital staff on bronchiolitis features and rationale for reducing cSpO2.
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Randomized Controlled Trial
The Effects of a Multifaceted Intervention to Improve Care Transitions Within an Accountable Care Organization: Results of a Stepped-Wedge Cluster-Randomized Trial.
Transitions from hospital to the ambulatory setting are high risk for patients in terms of adverse events, poor clinical outcomes, and readmission. ⋯ A multifaceted intervention was associated with a significant reduction in postdischarge adverse events but no difference in 30-day readmission rates.