Eliminating Monitor Overuse Trial (EMO Trial)

NARecruitingINTERVENTIONAL
Enrollment

32,357

Participants

Timeline

Start Date

December 1, 2021

Primary Completion Date

December 31, 2025

Study Completion Date

August 31, 2026

Conditions
Bronchiolitis Acute Viral
Interventions
BEHAVIORAL

Educational Outreach

Educational outreach includes staff-targeted educational materials and outreach sessions summarizing the current evidence and guideline recommendations for pulse oximetry use in bronchiolitis.

BEHAVIORAL

Audit & Feedback (unit level)

Weekly unit-level feedback of each hospital's guideline-concordant practice will be distributed to sites in the form of a visual dashboard that includes comparisons over time and between hospitals. The dashboard will then be shared locally on a weekly basis with clinicians in person and electronically.

BEHAVIORAL

Audit & Feedback (real time, individual-level)

Real-time feedback will occur at the individual clinician level. When collecting data on an individual patient, data collectors encountering guideline-discordant continuous monitoring are empowered to briefly ask any available clinician responsible for that patient's care, in a nonjudgmental way, about indications for monitoring that patient. The clinician is ultimately responsible for deciding if any changes are indicated.

BEHAVIORAL

Clinical Pathway Integrated into Electronic Health Record

Clinical pathways guide clinicians step-by-step through evidence-based care. Based on the existing guidelines for physiologic monitoring in bronchiolitis, the pathway will clearly specify (a) situations when it is appropriate to initiate intermittent SpO2 measurement instead of continuous SpO2 monitoring, and (b) when it is appropriate to discontinue continuous SpO2 monitoring altogether, and transition to intermittent SpO2 measurement. In order to be visible to clinicians as they perform patient care, the pathway will be integrated into the electronic health record at sites randomized to this intervention.

Trial Locations (58)

10032

RECRUITING

NYP-Morgan Stanley Children's Hospital, New York

10065

TERMINATED

Komansky Children's Hospital/New York Presbyterian Medical Center /Weill Cornell Medicine, New York

10467

TERMINATED

Children's Hospital at Montefiore, The Bronx

11040

RECRUITING

Cohen Children's Medical Center, New Hyde Park

12208

RECRUITING

Albany Medical Center, Albany

13210

RECRUITING

Upstate Golisano Children's Hospital, Syracuse

14642

RECRUITING

University of Rochester Golisano Children's Hospital, Rochester

15224

TERMINATED

Children's Hospital of Pittsburgh of UPMC, Pittsburgh

17033

WITHDRAWN

Penn State Hershey Children's Hospital, Hershey

18960

TERMINATED

CHOP Grand View Hospital, Sellersville

19104

RECRUITING

Children's Hospital of Philadelphia, Philadelphia

RECRUITING

University of Pennsylvania, Philadelphia

19406

RECRUITING

CHOP King of Prussia Hospital, King of Prussia

19611

WITHDRAWN

Reading Hospital, Tower Health, Reading

20010

RECRUITING

Children's National Medical Center, Washington D.C.

22042

RECRUITING

Inova Children's Hospital, Falls Church

23298

RECRUITING

Children's Hospital of Richmond at VCU, Richmond

23507

RECRUITING

Children's Hospital of The King's Daughters, Norfolk

25701

TERMINATED

Hoops Family Children's Hospital at Marshall University, Huntington

35233

TERMINATED

Children's of Alabama, Birmingham

37232

RECRUITING

Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville

43205

RECRUITING

Nationwide Children's Hospital, Columbus

44308

RECRUITING

Akron Children's Hospital, Akron

45229

RECRUITING

Cincinnati Children's Hospital Medical Center, Cincinnati

46202

RECRUITING

Riley Hospital for Children at IU Health, Indianapolis

48108

TERMINATED

CS Mott Children's Hospital, Ann Arbor

53226

RECRUITING

Children's Wisconsin, Milwaukee

55404

RECRUITING

Children's Minnesota, Minneapolis

60611

RECRUITING

Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago

ACTIVE_NOT_RECRUITING

Northwestern University, Chicago

64108

RECRUITING

Children's Mercy Kansas City, Kansas City

73104

RECRUITING

Children's Hospital at Oklahoma University Medical Center, Oklahoma City

75235

RECRUITING

Children's Medical Center Dallas, Dallas

77030

RECRUITING

Children's Memorial Hermann, Houston

RECRUITING

Texas Children's Hospital, Houston

77094

RECRUITING

Texas Children's Hospital West Campus, Houston

77384

RECRUITING

Texas Children's Hospital The Woodlands, The Woodlands

80045

RECRUITING

Children's Hospital Colorado, Aurora

84065

WITHDRAWN

Riverton Hospital, Riverton

84113

TERMINATED

Primary Children's Hospital, Salt Lake City

84604

WITHDRAWN

Utah Valley Hospital, Provo

85719

RECRUITING

Banner University Medical Center- Diamond Children's, Tucson

90027

RECRUITING

Children's Hospital Los Angeles, Los Angeles

92024

RECRUITING

Rady Children's Hospital/UCSD, Encinitas

92868

RECRUITING

Children's Hospital Orange County, Orange

93636

RECRUITING

Valley Children's Hospital, Madera

94304

RECRUITING

Lucile Packard Children's Hospital Stanford, Stanford

95616

RECRUITING

University of California Davis, Davis

98105

RECRUITING

Seattle Children's Hospital, Seattle

06106

WITHDRAWN

Connecticut Children's Medical Center, Hartford

06510

TERMINATED

Yale-New Haven Children's Hospital, New Haven

02111

RECRUITING

Tufts Medical Center, Boston

02115

RECRUITING

Boston Children's Hospital, Boston

03756

RECRUITING

Children's Hospital at Dartmouth-Hitchcock, Lebanon

08536

TERMINATED

CHOP Pediatric Care at Penn Medicine/Princeton Health, Princeton

08043

RECRUITING

CHOP Care Network at Virtua, Voorhees Township

05401

RECRUITING

University of Vermont Children's Hospital, Burlington

AB T3B 6A8

RECRUITING

Alberta Children's Hospital, Calgary

All Listed Sponsors
collaborator

National Heart, Lung, and Blood Institute (NHLBI)

NIH

collaborator

University of Pennsylvania

OTHER

collaborator

Boston Children's Hospital

OTHER

collaborator

Children's Hospital Medical Center, Cincinnati

OTHER

collaborator

Pediatric Research in Inpatient Settings (PRIS) Network

UNKNOWN

lead

Children's Hospital of Philadelphia

OTHER