Sustainability of the de-implementation of low-value care in infants with bronchiolitis: 2-year follow-up of a cluster randomised controlled trial

V Ramsden; FE Babl; L Haskell; C Wilson; S Middleton; R Schembri; A King; A Wallace; A Partyka; C Baldock; J Wong; K Steinmann; L Mills; N Phillips; N Poulter; S Jani; S Kenny; E Oakley; A Lithgow; P Wilson; E McInnes; S Dalziel; E Tavender

Journal article

Sustainability of the de-implementation of low-value care in infants with bronchiolitis: 2-year follow-up of a cluster randomised controlled trial

V Ramsden, FE Babl, L Haskell, C Wilson, S Middleton, R Schembri, A King, A Wallace, A Partyka, C Baldock, J Wong, K Steinmann, L Mills, N Phillips, N Poulter, S Jani, S Kenny, E Oakley, A Lithgow, P Wilson Show all

BMJ Quality and Safety | Published : 2026

DOI: 10.1136/bmjqs-2024-018135

Abstract

Background: In 2017, the PREDICT (Paediatric Research in Emergency Departments International Collaborative) network conducted a cluster randomised controlled trial (cRCT) at 26 Australian and New Zealand hospitals to improve bronchiolitis care. Findings demonstrated that targeted interventions significantly improved adherence with five evidence-based low-value bronchiolitis practices (no chest radiography, salbutamol, glucocorticoids, antibiotics and epinephrine) in the first 24 hours of hospitalisation (adjusted risk difference, 14.1%; 95% CI: 6.5% to 21.7%; p<0.001). During the intervention year (2017), intervention hospital (n=13) compliance was 85.1% (95% CI: 82.6% to 89.7%). This study ..

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