SIP Study

Asthma, pneumonia, and bronchiolitis are the leading causes of childhood hospitalization. The Society of Hospital Medicine (SHM) and the Principal Investigator, Dr. Suni Kaiser, conducted the SIP Study (Simultaneously Implementing Pathways for Improving Asthma, Pneumonia, and Bronchiolitis Care for Hospitalized Children) demonstrating that simultaneous implementation of multiple pathways for multiple pediatric conditions was feasible and effective. The multi-year study involved 37 hospitals and eight quality improvement (QI) mentors. Hospitals identified one internal site leader and were assigned one mentor under SHM’s Mentored Implementation program in which a hospitalist trained in QI methodology serves as a coach for the appointed hospital. Hospitals participating in SIP received clinical pathways and used five implementation strategies: QI mentor meetings, education, iterative changes, audit and feedback, and clinical decision support via electronic order sets. Baseline data was collected in addition to 12 months of intervention period performance data. Quantitative and qualitative data analysis were used to determine effectiveness of the interventions.

SHM was responsible for the recruiting of mentors and management of mentor meetings with hospitals. In addition to virtual monthly mentor meetings, mentors conducted a minimum of one site visit with each of their assigned hospitals to observe implementation practices and meet with key stakeholders with the goal of generating and sustaining project buy-in and support. Under Mentored Implementation, site leaders were instructed to assemble multidisciplinary teams to serve as critical partners in SIP QI initiatives. A representative diverse group of physicians, nurses, pharmacists, hospital leadership, respiratory therapists, and ICU and emergency department staff was recommended.