Impact of clinician feedback reports on antibiotic use in children hospitalized with community-acquired pneumonia
Feedback reports summarizing clinician performance are effective tools for improving antibiotic use in the ambulatory setting, but the effectiveness of feedback reports in the hospital setting is unknown. Quasi-experimental study conducted between December 2021 and November 2023 within a pediatric h...
Gespeichert in:
| Veröffentlicht in: | Clinical infectious diseases 2024-12 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | |
| container_start_page | |
| container_title | Clinical infectious diseases |
| container_volume | |
| creator | Chiotos, Kathleen Dutcher, Lauren Grundmeier, Robert W Meyahnwi, Didien Lautenbach, Ebbing Neuhauser, Melinda M Hicks, Lauri A Hamilton, Keith W Li, Yun Szymczak, Julia E Muller, Brandi M Congdon, Morgan Kane, Emily Hart, Jessica Utidjian, Levon Cressman, Leigh Jaskowiak-Barr, Anne Gerber, Jeffrey S |
| description | Feedback reports summarizing clinician performance are effective tools for improving antibiotic use in the ambulatory setting, but the effectiveness of feedback reports in the hospital setting is unknown.
Quasi-experimental study conducted between December 2021 and November 2023 within a pediatric health system measuring the impact of clinician feedback reports delivered by email and reviewed in a monthly meeting on appropriate antibiotic use in children hospitalized with community-acquired pneumonia (CAP). We used an interrupted time series analysis (ITSA) to estimate the immediate change and change over time in the proportion of CAP encounters adherent to validated metrics of antibiotic choice and duration, then used Poisson regression to estimate intervention effect as a rate ratio (RR).
Preintervention, 213 of 413 (52%) encounters received the appropriate antibiotic choice and duration, which increased to 308 of 387 (80%) postintervention. The ITSA demonstrated an immediate 18% increase in the proportion of CAP encounters receiving both the appropriate antibiotic choice and duration (95% confidence interval, 3-33%), with no further change over time (-0.3% per month, 95% CI -2-2%). In the Poisson model adjusted for age, sex, race, season, site, and intensive care unit admission, the intervention was associated with a 32% increase in the rate of appropriate antibiotic choice and duration (RR 1.32, 95% confidence interval 1.12-1.56, P |
| doi_str_mv | 10.1093/cid/ciae593 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146609847</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3146609847</sourcerecordid><originalsourceid>FETCH-LOGICAL-p568-f4389beabf0091eb0188cd6bebccd58147647e409176ac5cd18b95ef559e55c23</originalsourceid><addsrcrecordid>eNpNkM1LxDAQxYMorq6evEuOXqqJadLkKIsfCwte9l6SdMqOtkm3SZH1r7fgCh6Gebx5_HgMITec3XNmxIPHZh4L0ogTcsGlqAolDT_9pxfkMqUPxjjXTJ6ThTBKKq71Bdmv-8H6TGNLfYcBZ1CgLUDjrP-kIwxxzInGQG3I6DBm9HRKQDFQv8OuGSHQXUwDZtvhNzT0C_OO-tj3U8B8KKzfTzjO_hBg6mNAe0XOWtsluD7uJdm-PG9Xb8Xm_XW9etoUg1S6aEuhjQPrWsYMB8fmtr5RDpz3jdS8rFRZQTnfKmW99A3XzkhopTQgpX8US3L3ix3GuJ8g5brH5KHrbIA4pVrwUilmdFnN0dtjdHI9NPUwYm_HQ_33JfED39lsXw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3146609847</pqid></control><display><type>article</type><title>Impact of clinician feedback reports on antibiotic use in children hospitalized with community-acquired pneumonia</title><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Chiotos, Kathleen ; Dutcher, Lauren ; Grundmeier, Robert W ; Meyahnwi, Didien ; Lautenbach, Ebbing ; Neuhauser, Melinda M ; Hicks, Lauri A ; Hamilton, Keith W ; Li, Yun ; Szymczak, Julia E ; Muller, Brandi M ; Congdon, Morgan ; Kane, Emily ; Hart, Jessica ; Utidjian, Levon ; Cressman, Leigh ; Jaskowiak-Barr, Anne ; Gerber, Jeffrey S</creator><creatorcontrib>Chiotos, Kathleen ; Dutcher, Lauren ; Grundmeier, Robert W ; Meyahnwi, Didien ; Lautenbach, Ebbing ; Neuhauser, Melinda M ; Hicks, Lauri A ; Hamilton, Keith W ; Li, Yun ; Szymczak, Julia E ; Muller, Brandi M ; Congdon, Morgan ; Kane, Emily ; Hart, Jessica ; Utidjian, Levon ; Cressman, Leigh ; Jaskowiak-Barr, Anne ; Gerber, Jeffrey S</creatorcontrib><description>Feedback reports summarizing clinician performance are effective tools for improving antibiotic use in the ambulatory setting, but the effectiveness of feedback reports in the hospital setting is unknown.
Quasi-experimental study conducted between December 2021 and November 2023 within a pediatric health system measuring the impact of clinician feedback reports delivered by email and reviewed in a monthly meeting on appropriate antibiotic use in children hospitalized with community-acquired pneumonia (CAP). We used an interrupted time series analysis (ITSA) to estimate the immediate change and change over time in the proportion of CAP encounters adherent to validated metrics of antibiotic choice and duration, then used Poisson regression to estimate intervention effect as a rate ratio (RR).
Preintervention, 213 of 413 (52%) encounters received the appropriate antibiotic choice and duration, which increased to 308 of 387 (80%) postintervention. The ITSA demonstrated an immediate 18% increase in the proportion of CAP encounters receiving both the appropriate antibiotic choice and duration (95% confidence interval, 3-33%), with no further change over time (-0.3% per month, 95% CI -2-2%). In the Poisson model adjusted for age, sex, race, season, site, and intensive care unit admission, the intervention was associated with a 32% increase in the rate of appropriate antibiotic choice and duration (RR 1.32, 95% confidence interval 1.12-1.56, P <0.01). No difference in length of stay or revisits were detected postintervention.
The intervention was associated with an increase in clinician adherence to antibiotic choice and duration recommendations for children hospitalized with CAP.</description><identifier>ISSN: 1537-6591</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciae593</identifier><identifier>PMID: 39656188</identifier><language>eng</language><publisher>United States</publisher><ispartof>Clinical infectious diseases, 2024-12</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-5011-7950 ; 0000-0002-2383-9357 ; 0000-0002-2189-108X ; 0000-0002-3076-3186 ; 0000-0002-3230-8670 ; 0000-0002-0204-8708 ; 0000-0002-8528-0480</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39656188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chiotos, Kathleen</creatorcontrib><creatorcontrib>Dutcher, Lauren</creatorcontrib><creatorcontrib>Grundmeier, Robert W</creatorcontrib><creatorcontrib>Meyahnwi, Didien</creatorcontrib><creatorcontrib>Lautenbach, Ebbing</creatorcontrib><creatorcontrib>Neuhauser, Melinda M</creatorcontrib><creatorcontrib>Hicks, Lauri A</creatorcontrib><creatorcontrib>Hamilton, Keith W</creatorcontrib><creatorcontrib>Li, Yun</creatorcontrib><creatorcontrib>Szymczak, Julia E</creatorcontrib><creatorcontrib>Muller, Brandi M</creatorcontrib><creatorcontrib>Congdon, Morgan</creatorcontrib><creatorcontrib>Kane, Emily</creatorcontrib><creatorcontrib>Hart, Jessica</creatorcontrib><creatorcontrib>Utidjian, Levon</creatorcontrib><creatorcontrib>Cressman, Leigh</creatorcontrib><creatorcontrib>Jaskowiak-Barr, Anne</creatorcontrib><creatorcontrib>Gerber, Jeffrey S</creatorcontrib><title>Impact of clinician feedback reports on antibiotic use in children hospitalized with community-acquired pneumonia</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Feedback reports summarizing clinician performance are effective tools for improving antibiotic use in the ambulatory setting, but the effectiveness of feedback reports in the hospital setting is unknown.
Quasi-experimental study conducted between December 2021 and November 2023 within a pediatric health system measuring the impact of clinician feedback reports delivered by email and reviewed in a monthly meeting on appropriate antibiotic use in children hospitalized with community-acquired pneumonia (CAP). We used an interrupted time series analysis (ITSA) to estimate the immediate change and change over time in the proportion of CAP encounters adherent to validated metrics of antibiotic choice and duration, then used Poisson regression to estimate intervention effect as a rate ratio (RR).
Preintervention, 213 of 413 (52%) encounters received the appropriate antibiotic choice and duration, which increased to 308 of 387 (80%) postintervention. The ITSA demonstrated an immediate 18% increase in the proportion of CAP encounters receiving both the appropriate antibiotic choice and duration (95% confidence interval, 3-33%), with no further change over time (-0.3% per month, 95% CI -2-2%). In the Poisson model adjusted for age, sex, race, season, site, and intensive care unit admission, the intervention was associated with a 32% increase in the rate of appropriate antibiotic choice and duration (RR 1.32, 95% confidence interval 1.12-1.56, P <0.01). No difference in length of stay or revisits were detected postintervention.
The intervention was associated with an increase in clinician adherence to antibiotic choice and duration recommendations for children hospitalized with CAP.</description><issn>1537-6591</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpNkM1LxDAQxYMorq6evEuOXqqJadLkKIsfCwte9l6SdMqOtkm3SZH1r7fgCh6Gebx5_HgMITec3XNmxIPHZh4L0ogTcsGlqAolDT_9pxfkMqUPxjjXTJ6ThTBKKq71Bdmv-8H6TGNLfYcBZ1CgLUDjrP-kIwxxzInGQG3I6DBm9HRKQDFQv8OuGSHQXUwDZtvhNzT0C_OO-tj3U8B8KKzfTzjO_hBg6mNAe0XOWtsluD7uJdm-PG9Xb8Xm_XW9etoUg1S6aEuhjQPrWsYMB8fmtr5RDpz3jdS8rFRZQTnfKmW99A3XzkhopTQgpX8US3L3ix3GuJ8g5brH5KHrbIA4pVrwUilmdFnN0dtjdHI9NPUwYm_HQ_33JfED39lsXw</recordid><startdate>20241203</startdate><enddate>20241203</enddate><creator>Chiotos, Kathleen</creator><creator>Dutcher, Lauren</creator><creator>Grundmeier, Robert W</creator><creator>Meyahnwi, Didien</creator><creator>Lautenbach, Ebbing</creator><creator>Neuhauser, Melinda M</creator><creator>Hicks, Lauri A</creator><creator>Hamilton, Keith W</creator><creator>Li, Yun</creator><creator>Szymczak, Julia E</creator><creator>Muller, Brandi M</creator><creator>Congdon, Morgan</creator><creator>Kane, Emily</creator><creator>Hart, Jessica</creator><creator>Utidjian, Levon</creator><creator>Cressman, Leigh</creator><creator>Jaskowiak-Barr, Anne</creator><creator>Gerber, Jeffrey S</creator><scope>NPM</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5011-7950</orcidid><orcidid>https://orcid.org/0000-0002-2383-9357</orcidid><orcidid>https://orcid.org/0000-0002-2189-108X</orcidid><orcidid>https://orcid.org/0000-0002-3076-3186</orcidid><orcidid>https://orcid.org/0000-0002-3230-8670</orcidid><orcidid>https://orcid.org/0000-0002-0204-8708</orcidid><orcidid>https://orcid.org/0000-0002-8528-0480</orcidid></search><sort><creationdate>20241203</creationdate><title>Impact of clinician feedback reports on antibiotic use in children hospitalized with community-acquired pneumonia</title><author>Chiotos, Kathleen ; Dutcher, Lauren ; Grundmeier, Robert W ; Meyahnwi, Didien ; Lautenbach, Ebbing ; Neuhauser, Melinda M ; Hicks, Lauri A ; Hamilton, Keith W ; Li, Yun ; Szymczak, Julia E ; Muller, Brandi M ; Congdon, Morgan ; Kane, Emily ; Hart, Jessica ; Utidjian, Levon ; Cressman, Leigh ; Jaskowiak-Barr, Anne ; Gerber, Jeffrey S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p568-f4389beabf0091eb0188cd6bebccd58147647e409176ac5cd18b95ef559e55c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chiotos, Kathleen</creatorcontrib><creatorcontrib>Dutcher, Lauren</creatorcontrib><creatorcontrib>Grundmeier, Robert W</creatorcontrib><creatorcontrib>Meyahnwi, Didien</creatorcontrib><creatorcontrib>Lautenbach, Ebbing</creatorcontrib><creatorcontrib>Neuhauser, Melinda M</creatorcontrib><creatorcontrib>Hicks, Lauri A</creatorcontrib><creatorcontrib>Hamilton, Keith W</creatorcontrib><creatorcontrib>Li, Yun</creatorcontrib><creatorcontrib>Szymczak, Julia E</creatorcontrib><creatorcontrib>Muller, Brandi M</creatorcontrib><creatorcontrib>Congdon, Morgan</creatorcontrib><creatorcontrib>Kane, Emily</creatorcontrib><creatorcontrib>Hart, Jessica</creatorcontrib><creatorcontrib>Utidjian, Levon</creatorcontrib><creatorcontrib>Cressman, Leigh</creatorcontrib><creatorcontrib>Jaskowiak-Barr, Anne</creatorcontrib><creatorcontrib>Gerber, Jeffrey S</creatorcontrib><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chiotos, Kathleen</au><au>Dutcher, Lauren</au><au>Grundmeier, Robert W</au><au>Meyahnwi, Didien</au><au>Lautenbach, Ebbing</au><au>Neuhauser, Melinda M</au><au>Hicks, Lauri A</au><au>Hamilton, Keith W</au><au>Li, Yun</au><au>Szymczak, Julia E</au><au>Muller, Brandi M</au><au>Congdon, Morgan</au><au>Kane, Emily</au><au>Hart, Jessica</au><au>Utidjian, Levon</au><au>Cressman, Leigh</au><au>Jaskowiak-Barr, Anne</au><au>Gerber, Jeffrey S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of clinician feedback reports on antibiotic use in children hospitalized with community-acquired pneumonia</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2024-12-03</date><risdate>2024</risdate><issn>1537-6591</issn><eissn>1537-6591</eissn><abstract>Feedback reports summarizing clinician performance are effective tools for improving antibiotic use in the ambulatory setting, but the effectiveness of feedback reports in the hospital setting is unknown.
Quasi-experimental study conducted between December 2021 and November 2023 within a pediatric health system measuring the impact of clinician feedback reports delivered by email and reviewed in a monthly meeting on appropriate antibiotic use in children hospitalized with community-acquired pneumonia (CAP). We used an interrupted time series analysis (ITSA) to estimate the immediate change and change over time in the proportion of CAP encounters adherent to validated metrics of antibiotic choice and duration, then used Poisson regression to estimate intervention effect as a rate ratio (RR).
Preintervention, 213 of 413 (52%) encounters received the appropriate antibiotic choice and duration, which increased to 308 of 387 (80%) postintervention. The ITSA demonstrated an immediate 18% increase in the proportion of CAP encounters receiving both the appropriate antibiotic choice and duration (95% confidence interval, 3-33%), with no further change over time (-0.3% per month, 95% CI -2-2%). In the Poisson model adjusted for age, sex, race, season, site, and intensive care unit admission, the intervention was associated with a 32% increase in the rate of appropriate antibiotic choice and duration (RR 1.32, 95% confidence interval 1.12-1.56, P <0.01). No difference in length of stay or revisits were detected postintervention.
The intervention was associated with an increase in clinician adherence to antibiotic choice and duration recommendations for children hospitalized with CAP.</abstract><cop>United States</cop><pmid>39656188</pmid><doi>10.1093/cid/ciae593</doi><orcidid>https://orcid.org/0000-0001-5011-7950</orcidid><orcidid>https://orcid.org/0000-0002-2383-9357</orcidid><orcidid>https://orcid.org/0000-0002-2189-108X</orcidid><orcidid>https://orcid.org/0000-0002-3076-3186</orcidid><orcidid>https://orcid.org/0000-0002-3230-8670</orcidid><orcidid>https://orcid.org/0000-0002-0204-8708</orcidid><orcidid>https://orcid.org/0000-0002-8528-0480</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1537-6591 |
| ispartof | Clinical infectious diseases, 2024-12 |
| issn | 1537-6591 1537-6591 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3146609847 |
| source | Oxford University Press Journals All Titles (1996-Current) |
| title | Impact of clinician feedback reports on antibiotic use in children hospitalized with community-acquired pneumonia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T09%3A24%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20clinician%20feedback%20reports%20on%20antibiotic%20use%20in%20children%20hospitalized%20with%20community-acquired%20pneumonia&rft.jtitle=Clinical%20infectious%20diseases&rft.au=Chiotos,%20Kathleen&rft.date=2024-12-03&rft.issn=1537-6591&rft.eissn=1537-6591&rft_id=info:doi/10.1093/cid/ciae593&rft_dat=%3Cproquest_pubme%3E3146609847%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3146609847&rft_id=info:pmid/39656188&rfr_iscdi=true |