Case Study: Main Line Health Bryn Mawr Hospital 2020 HAP Achievement Award

Standardization of High Flow Nasal Cannula (HFNC) Oxygen Therapy Management for Pediatric Bronchiolitis in the Emergency Department

After identifying an unusually transfer rate of respiratory distress (bronchiolitis) pediatric patients to a dedicated pediatric children’s hospital, Bryn Mawr Hospital’s team set out to better address and manage pediatric patient respiratory distress symptoms and reduce patient transfer.

An interdisciplinary team was assembled to:

• Discuss current practice
• Review best practice
• Standardize pediatric bronchiolitis HFNC guidelines used in the emergency department

Through their efforts, the hospital was able to identify:

• An inability to stabilize and manage symptoms related to respiratory distress (primarily Bronchiolitis) using their current process
• A high variability in their HFNC flow settings and that we were using lower flow max settings for this patient population than noted in the literature

After changes to their procedures, the hospital experienced a significant reduction (64% to 0%) of bronchiolitis patients failing HFNC and requiring transfer to an external dedicated children's hospital over a 3-month timeframe and a 25% reduction the same month one year later.

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Topics: Quality Initiatives

Revision Date: 8/1/2020

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