Background

Background: Worldwide, biggest killer of children under 5 years of age, is pneumonia. The clinicians use chest x=ray for diagnosing and following it up against the guidelines and consequent hazards. We collaborated with American Academy of Pediatrics initiative of Value in inpatient pediatrics (VIP) Improving Community Acquired Pneumonia (ICAP) Quality improvement project to change the paradigm.

Objectives: To decrease the use of chest x-ray to 10% for initial diagnosis and to decrease the use of follow up chest x-ray to less than 10% in inpatients in under 5 age group.

Methods

We implemented series of interventions including information dissemination, interactive discussions and webinars with all care providers. The rates of chest x-ray use were determined by individual chart review at baseline and then over 5 improvement cycles. The Baseline percentages were compared with the final cycle using Fisher’s exact test.

Results

Rates of chest x-ray use decreased for initial diagnosis from 100% to 50% and rate of follow up chest x-ray decreased more than the set goal.

Conclusions

This real time experience of practicality of implementation of guidelines with such approach can be an impetus for decreasing the use of chest x-ray for managing pediatric pneumonia by the clinicians.