Does algorithm-informed care for gastroenteritis result in better outcomes?

Algorithms drawn from evidence-based guidelines (EBGs) are commonly used for the treatment of gastroenteritis. A new report in Pediatrics investigated whether the implementation of EBGs in the pediatric emergency department (ED) could lead to a reduction in intravenous (IV) fluid administration and health care costs.¹

Through a single-center quality improvement initiative that ran between 2010 and 2016, investigators sought to reduce the percentage of patients who had gastroenteritis and required rehydration with IV fluids. An EBG assigned each patient a dehydration score along with a rehydration strategy that was based on presenting signs and symptoms.

Over the course of the initiative, 7145 patients met the inclusion criteria. The median age of the participants was 17 months. Following implementation of the quality improvement initiative, the use of IV fluid decreased on average from 15% to 9%. Overall the average episode of care-related costs decreased from $599 to $410. Improvements were seeing in the ED length of stay, the rate of admission, and the rate of return visits.

The researchers concluded that their quality improvement initiative led to lower costs, shorter stays, and a reduction in the frequency of IV administration. The results support the use of EBG to improve care outcomes.

Reference:

1.Creedon JK, Eisenberg M, Monuteaux MC, Samnaliev M, Levy J. Reduction in resources and cost for gastroenteritis through implementation of dehydration pathway. Pediatrics. 2020;145(6):e20191553. doi:10.1542/peds.2019-1553