PMID- 33929945
OWN - NLM
STAT- MEDLINE
DCOM- 20210903
LR  - 20220503
IS  - 1553-5606 (Electronic)
IS  - 1553-5592 (Print)
IS  - 1553-5592 (Linking)
VI  - 16
IP  - 5
DP  - 2021 May
TI  - Nine Seasons of a Bronchiolitis Observation Unit and Home Oxygen Therapy 
      Protocol.
PG  - 261-266
LID - 10.12788/jhm.3576 [doi]
AB  - BACKGROUND: We implemented an observation unit and home oxygen therapy (OU-HOT) 
      protocol at our children's hospital during the 2010-2011 winter season to 
      facilitate earlier discharge of children hospitalized with bronchiolitis. An 
      earlier study demonstrated substantial reductions in inpatient length of stay and 
      costs in the first year after implementation. OBJECTIVE: Evaluate long-term 
      reductions in length of stay and cost. DESIGN, SETTING, AND PARTICIPANTS: 
      Interrupted time-series analysis, adjusting for patient demographic factors and 
      disease severity. Participants were children aged 3 to 24 months and hospitalized 
      with bronchiolitis from 2007 to 2019. INTERVENTION: OU-HOT protocol 
      implementation. MAIN OUTCOME AND MEASURES: Hospital length of stay. Process 
      measures were the percentage of patients discharged from the OU; percentage of 
      patients discharged with HOT. Balancing measures were 7-day hospital revisit 
      rates; annual per-population bronchiolitis admission rates. Secondary outcomes 
      were inflation-adjusted cost per episode of care and discharges within 24 hours. 
      RESULTS: A total of 7,116 patients met inclusion criteria. The OU-HOT protocol 
      was associated with immediate decreases in mean length of stay (-30.6 hours; 95% 
      CI, -37.1 to -24.2 hours) and mean cost per episode of care (-$4,181; 95% CI, 
      -$4,829 to -$3,533). These findings were sustained for 9 years after 
      implementation. Hospital revisit rates did not increase immediately (-1.1% 
      immediate change; 95% CI, -1.8% to -0.4%), but a small increase in revisits was 
      observed over time (change in slope 0.4% per season, 95% CI, 0.1%-0.8%). 
      CONCLUSION: The OU-HOT protocol was associated with sustained reductions in 
      length of stay and cost, representing a promising strategy to reduce the 
      inpatient burden of bronchiolitis.
FAU - Ohlsen, Timothy J D
AU  - Ohlsen TJD
AD  - Department of Pediatrics, Division of Inpatient Medicine, University of Utah, 
      Salt Lake City, Utah.
FAU - Knudson, Alexander M
AU  - Knudson AM
AD  - University of Utah School of Medicine, Salt Lake City, Utah.
FAU - Korgenski, E Kent
AU  - Korgenski EK
AD  - Department of Pediatrics, Division of Inpatient Medicine, University of Utah, 
      Salt Lake City, Utah.
FAU - Sandweiss, David R
AU  - Sandweiss DR
AD  - Department of Pediatrics, Division of Emergency Medicine, University of Utah, 
      Salt Lake City, Utah.
FAU - Hofmann, Michelle G
AU  - Hofmann MG
AD  - Department of Pediatrics, Division of General Pediatrics, Salt Lake City, Utah.
FAU - Glasgow, Tiffany S
AU  - Glasgow TS
AD  - Department of Pediatrics, Division of Inpatient Medicine, University of Utah, 
      Salt Lake City, Utah.
FAU - Coon, Eric R
AU  - Coon ER
AD  - Department of Pediatrics, Division of Inpatient Medicine, University of Utah, 
      Salt Lake City, Utah.
LA  - eng
GR  - UL1 RR025764/RR/NCRR NIH HHS/United States
GR  - UL1 TR000105/TR/NCATS NIH HHS/United States
GR  - UL1 TR001067/TR/NCATS NIH HHS/United States
GR  - UL1 TR002538/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Hosp Med
JT  - Journal of hospital medicine
JID - 101271025
RN  - S88TT14065 (Oxygen)
SB  - IM
CIN - J Hosp Med. 2021 May;16(5):319. PMID: 33929954
MH  - *Bronchiolitis/epidemiology/therapy
MH  - Child
MH  - *Clinical Observation Units
MH  - Humans
MH  - Infant
MH  - Length of Stay
MH  - Oxygen
MH  - Oxygen Inhalation Therapy
MH  - Seasons
PMC - PMC8086993
EDAT- 2021/05/01 06:00
MHDA- 2021/09/04 06:00
PMCR- 2022/05/01
CRDT- 2021/04/30 17:29
PHST- 2020/05/23 00:00 [received]
PHST- 2020/11/22 00:00 [accepted]
PHST- 2021/04/30 17:29 [entrez]
PHST- 2021/05/01 06:00 [pubmed]
PHST- 2021/09/04 06:00 [medline]
PHST- 2022/05/01 00:00 [pmc-release]
AID - jhm.3576 [pii]
AID - 0160261 [pii]
AID - 10.12788/jhm.3576 [doi]
PST - ppublish
SO  - J Hosp Med. 2021 May;16(5):261-266. doi: 10.12788/jhm.3576.