Value in Inpatient Pediatrics Network

Benchmarking Bronchiolitis

Bronchiolitis benchmarking is the inaugural project of the VIP Network. We started this project in 2008 and have collected and shared data for 2007-2009 with our members. We will continue to collect yearly data and use this as a platform to launch bronchiolitis improvement collaborative projects.

Our bronchiolitis data includes each institutions total non-ICU hospital admissions with the primary diagnosis of bronchiolitis based on ICD-9 codes 466.11 and 466.19 (with certain chronic disease exclusions).  We are currently tracking:

  1. Outcomes: LOS, readmissions within 72 hours for the same diagnosis
  2. Utilization: steroids, bronchodilators, total number of bronchodilator doses, chest x-rays and RSV testing
  3. Variable Direct Costs

2007 – 24 centers reported on 3097 admissions

2008 – 26 centers reported on 3744 admissions

2009 – 20 centers reported on 3628 admissions

85% of the network members are non-freestanding children’s facilities, either children’s hospitals within hospitals or pediatric floors within larger hospitals

While overall network means for utilization of our chosen non-evidence based therapies have remained constant, certain centers have made significant gains in decreasing utilization and we are in the process of facilitating the dissemination of the lessons learned at successful centers throughout the network. Each participating center receives a yearly report which shows them where they rank compared to peers and we have publicly honored the high performers within the network so that other members can seek out expertise to apply to their particular areas of concern Although we have collected an impressive array of data, their dissemination is not an end unto itself.

We are a network open to any group willing to improve the value of their care. The fact that between 20 and 30 hospitalist groups have participated in our efforts without funding or additional benefits speaks to the true power of our network. While our ultimate success may be measured by improvements in outcomes, given the scale and diversity of our network, establishing a committed and collaborative physician workforce is a giant leap towards sustainable change.