Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Asthma, pneumonia, and bronchiolitis are the top causes of childhood hospitalization in the United States, leading to over 350,000 hospitalizations and ≈$2 billion in costs annually. The majority of these hospitalizations occur in general/community hospitals. Poor guideline adoption by clinicians contributes to poor health outcomes for children hospitalized with these illnesses, including longer recovery time/hospital stay, higher rates of intensive care unit transfer, and increased risk of hospital readmission. A prior single-center study at a children's hospital tested a multicondition clinical pathway intervention (simultaneous implementation of multiple pathways for multiple pediatric conditions) and demonstrated improved clinician guideline adherence and patient health outcomes. This intervention has not yet been studied in community hospitals, which face unique implementation barriers. ⋯ This hybrid trial will lead to a comprehensive understanding of how to pragmatically and sustainably implement a multicondition pathway intervention in community hospitals and an assessment of its effects. Enrollment began in July 2022 and is projected to be completed in September 2024. Primary analysis completion is anticipated in March 2025, with reporting of results following.
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People with disability (PWD) face challenges accessing healthcare. Websites are a public-facing resource that can help PWD determine if a hospital can accommodate their needs, yet few studies have described whether hospital websites contain adequate accommodation information. ⋯ Information about disability accommodations is sparse on hospital websites. Comprehensive and actionable communication about accommodations is needed to better protect PWD's rights to accessible healthcare.