I-DECIDE After Bronchiolitis Hospitalization
Cluster Randomized Trial of a Moderate vs High Resource Implementation Strategy to Increase As-needed Post-hospitalization Follow-up for Children With Bronchiolitis
Seattle Children's Hospital
2,700 participants
Nov 1, 2025
INTERVENTIONAL
Conditions
Summary
Although automatic follow-up is a nearly universal practice, research has shown that these visits are often unnecessary after hospitalizations caused by bronchiolitis. Despite endorsement by national pediatric authorities, robust evidence, and family enthusiasm for as-needed (PRN) follow-up, it remains substantially underutilized for children hospitalized for bronchiolitis. The goal of I-DECIDE is to compare the effects of two multi-component implementation strategies, both of which aim to (a) increase PRN follow-up prescribing by hospitalists (physicians who care for hospitalized children) and (b) decrease unnecessary follow-up visit attendance by families.
Eligibility
Inclusion Criteria1
- Primary diagnosis of bronchiolitis, discharged by a generalist inpatient service from a non-ICU, non-emergency department, non-step down unit
Exclusion Criteria2
- Children with a history of gestational age \<28 weeks, chronic lung disease, complex or hemodynamically significant heart disease, immunodeficiency, or neuromuscular disease
- Children being discharged with home oxygen therapy
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Interventions
The moderate-resource implementation strategy includes educational outreach (including family-facing materials to support follow-up decision making), audit and feedback (review of clinician performance, captured in a structured report), and materials for clinical decision support.
The high-resource implementation strategy includes all of the moderate resource components, plus two forms of external facilitation: small-group facilitation and expert clinical decision support coach-led facilitation. In total, the high-resource implementation strategy includes educational outreach (including family-facing materials to support follow-up decision-making), audit and feedback (review of clinician performance, captured in a structured report), materials for clinical decision support, small-group facilitation and expert clinical decision support coach-led facilitation.
Locations(56)
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NCT07243652