NCT05206695

Brief Summary

This study's objective is to identify and test pragmatic and sustainable strategies for implementing a multi-condition clinical pathway intervention for children hospitalized with asthma, pneumonia, or bronchiolitis in community hospitals. The hypothesis is that the multi-condition pathway intervention will be associated with significantly greater increases in clinicians' adoption of evidence-based practices compared to control. The study is a pragmatic, cluster-randomized trial in US community hospitals. The primary outcome will be adoption of evidence-based practices over a sustained period of 2 years. Secondary outcomes include length of hospital stay, intensive care unit transfer, and hospital readmission/emergency department revisit.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
11,760

participants targeted

Target at P75+ for not_applicable asthma

Timeline
Completed

Started May 2022

Typical duration for not_applicable asthma

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 11, 2022

Completed
14 days until next milestone

First Posted

Study publicly available on registry

January 25, 2022

Completed
4 months until next milestone

Study Start

First participant enrolled

May 13, 2022

Completed
3.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 21, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 21, 2025

Completed
Last Updated

April 20, 2026

Status Verified

April 1, 2026

Enrollment Period

3.4 years

First QC Date

January 11, 2022

Last Update Submit

April 15, 2026

Conditions

Keywords

ChildrenClinical pathwaysHospital

Outcome Measures

Primary Outcomes (7)

  • Pneumonia Evidence Based Practice 1

    Administration of narrow spectrum antibiotic

    During a hospitalization, approximately 2 days

  • Pneumonia Evidence Based Practice 2

    No prescription of macrolide antibiotics

    During a hospitalization, approximately 2 days

  • Asthma Evidence Based Practice 1

    Prescription of inhaled corticosteroids for children greater than or equal to 5 years-old

    During a hospitalization, approximately 2 days

  • Asthma Evidence Based Practice 2

    Use of metered-dose inhalers

    During a hospitalization, approximately 2 days

  • Asthma Evidence Based Practice 3

    Use of an asthma pathway/bronchodilator weaning protocol

    During a hospitalization, approximately 2 days

  • Bronchiolitis Evidence Based Practice 1

    No administration of albuterol

    During a hospitalization, approximately 2 days

  • Bronchiolitis Evidence Based Practice 2

    No chest radiographs

    During a hospitalization, approximately 2 days

Secondary Outcomes (3)

  • Length of Hospital Stay

    During a hospitalization, approximately 2 days

  • Transfer to Intensive Care

    During a hospitalization, approximately 2 days

  • 30-day Hospital Readmission or Emergency Department Revisit

    30 days after hospital discharge

Study Arms (2)

Multi-condition Pathway Intervention

EXPERIMENTAL

The multi-condition pathway intervention consists of pathways clinicians select from to guide the care of children with asthma, pneumonia, or bronchiolitis. Key implementation strategies include audit and feedback, plan-do-study-act cycles, electronic order sets, and mentoring/facilitation.

Behavioral: Multi-condition Pathway Intervention

Standard of Care

NO INTERVENTION

Hospitals randomized to the control arm will not receive the multi-condition pathway intervention or any external supports for implementation. They will continue to provide current standards of care.

Interventions

See Experimental/Arm 1 description

Multi-condition Pathway Intervention

Eligibility Criteria

AgeUp to 17 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Primary diagnosis of asthma AND age \>2 to \<18 years-old at time of admission to the hospital OR
  • Primary diagnosis of pneumonia AND age \>2 months and \<18 years at time of admission to the hospital OR
  • Primary diagnosis of bronchiolitis AND age \<2 years at time of admission to the hospital

You may not qualify if:

  • Diagnosis of SARS-CoV-2
  • Transfer in from another inpatient facility
  • Pre-existing chronic illnesses (e.g., lung disease, cardiovascular disease, neurologic disorders)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of California, San Francisco

San Francisco, California, 94153, United States

Location

MeSH Terms

Conditions

AsthmaPneumoniaBronchiolitis

Condition Hierarchy (Ancestors)

Bronchial DiseasesRespiratory Tract DiseasesLung Diseases, ObstructiveLung DiseasesRespiratory HypersensitivityHypersensitivity, ImmediateHypersensitivityImmune System DiseasesRespiratory Tract InfectionsInfectionsBronchitis

Study Officials

  • Sunitha V Kaiser, MD, MSc

    University of California, San Francisco

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Participants, clinicians, and investigators cannot be masked due to the nature of the intervention. However, outcomes assessors will be masked.
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Model Details: Participating hospitals will be randomized into either an intervention group (will test simultaneous implementation of 3 clinical pathways) or control (will continue to provide standard care)
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 11, 2022

First Posted

January 25, 2022

Study Start

May 13, 2022

Primary Completion

October 21, 2025

Study Completion

October 21, 2025

Last Updated

April 20, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will share

Data generated under this project will be administered in accordance with the policies of the University of California San Francisco (UCSF) and NIH/NHLBI. The Final Research Data (the dataset necessary to document and support research findings) will be made available for sharing after the main research findings from the final data set have been accepted for publication in a peer-reviewed journal. Prior to sharing, data will be redacted to strip all direct identifiers of hospitals (no identifiers of patients/individuals will be collected).

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
The data will become available after peer-reviewed publication, and it will be available for 3 years.

Locations