Effectiveness of a Practice-Based, Multimodal Quality Improvement Intervention for Gastroenteritis Within a Medicaid Managed Care Network

Acute gastroenteritis results in 220,000 hospitalizations yearly in the United States. The substantial geographic variation in gastroenteritis care, coupled with the evidence of effective treatment of dehydration in nonhospital settings, suggests that the majority of these hospitalizations are avoid...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2007-09, Vol.120 (3), p.e644-e650
Main Authors: Zolotor, Adam J, Randolph, Greg D, Johnson, Julie K, Wegner, Steven, Edwards, Lori, Powell, Carol, Esporas, Megan H
Format: Article
Language:English
Subjects:
Acute Disease
Child, Preschool
Education, Medical, Continuing
Effectiveness studies
Gastroenteritis - therapy
Gastroenterology
Gastrointestinal diseases
Hospitalization
Humans
Managed care
Managed Care Programs - organization & administration
Medicaid
Patient Admission - statistics & numerical data
Patient Education as Topic
Pediatrics
Pilot Projects
Practice Guidelines as Topic
Program Evaluation
Quality Assurance, Health Care
Quality of care
Regional Medical Programs - organization & administration
Rehydration Solutions - therapeutic use
United States
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Summary:Acute gastroenteritis results in 220,000 hospitalizations yearly in the United States. The substantial geographic variation in gastroenteritis care, coupled with the evidence of effective treatment of dehydration in nonhospital settings, suggests that the majority of these hospitalizations are avoidable. We sought to decrease hospitalizations for gastroenteritis by using practice-based, multimodal quality improvement methods that target multiple care processes to make them consistent with evidence-based guidelines. We used a controlled before/after study design to evaluate a quality improvement intervention in a 20-practice Medicaid network. All 20 practices participated in continuing education sessions; received free oral rehydration solution, patient education materials, and performance feedback; and participated in a follow-up conference call. Three practices were chosen to develop and pilot office-process changes. These practices formed interdisciplinary teams to develop and test changes and collaborated with project faculty and each other. They shared their learning with the other 17 practices via a conference call and toolkit. We compared before/after gastroenteritis hospital admissions for children
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2006-1749