CHAT Bronchiolitis Key Driver Diagram AIM (S) KEY DRIVERS (WHAT) CHANGE STRATEGIES (HOW) Decrease the over utilization of resources (tests, non-evidence based therapies, LOS, readmissions) for patients with bronchiolitis of 10% by July 2018 *goal to be confirmed with baseline data analysis Prevention: These strategies will focus on preventing the spread and contraction of bronchiolitis. Change Strategies 1-3 Appropriate hand hygiene Inquire about smoke exposure and counsel about cessation if positive for smoke exposure Educate hospital personnel, community clinicians, and families about evidence-based diagnosis, treatment and prevention of bronchiolitis Diagnose bronchiolitis and assess severity based on History and Physical Exam Recommend to not obtain for diagnosis of bronchiolitis CXR Laboratory studies Recommend to not use Steroids Antibiotics Albuterol Epinephrine (inpatients) Hypertonic saline (ED) CPT Recommended to not use O² if SPO² >90% Consider NOT using continuous pulse ox USE NG or IVF to hydrate patients that can’t hydrate themselves. Use a standardized protocol for starting High Flow Use a standardized oxygen weaning protocol Diagnosis: These strategies will decrease unnecessary testing for patients diagnosed with bronchiolitis Change Strategies 4-5 Treatment: These strategies will Decrease unnecessary Interventions and therapies used to treat bronchiolitis. Change Strategies 6-11