{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:50:55Z","timestamp":1791611455727,"version":"4.3.4"},"reference-count":12,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>In 2016, the American Academy of Pediatrics published the Brief Resolved Unexplained Event (BRUE) Clinical Practice Guideline (CPG). A multicenter quality improvement (QI) collaborative aimed to improve CPG adherence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A QI collaborative of 15 hospitals aimed to improve testing adherence, the hospitalization of lower-risk infants, the correct use of diagnostic criteria, and risk classification. Interventions included CPG education, documentation practices, clinical pathways, and electronic medical record integration. By using medical record review, care of emergency department (ED) and inpatient patients meeting BRUE criteria was displayed via control or run charts for 3 time periods: pre-CPG publication (October 2015 to June 2016), post-CPG publication (July 2016 to September 2018), and collaborative (April 2019 to June 2020). Collaborative learning was used to identify and mitigate barriers to iterative improvement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 1756 infants met BRUE criteria. After CPG publication, testing adherence improved from 56% to 64% and hospitalization decreased from 49% to 27% for lower-risk infants, but additional improvements were not demonstrated during the collaborative period. During the collaborative period, correct risk classification for hospitalized infants improved from 26% to 49% (ED) and 15% to 33% (inpatient) and the documentation of BRUE risk factors for hospitalized infants improved from 84% to 91% (ED).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>A national BRUE QI collaborative enhanced BRUE-related hospital outcomes and processes. Sites did not improve testing and hospitalization beyond the gains made after CPG publication, but they did shift the BRUE definition and risk classification. The incorporation of caregiver perspectives and the use of shared decision-making tools may further improve care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-060909","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T08:06:56Z","timestamp":1705478816000},"source":"Crossref","is-referenced-by-count":6,"title":["Learning From a National Quality Improvement Collaborative for Brief Resolved Unexplained Events"],"prefix":"10.1542","volume":"153","author":[{"given":"Daniela","family":"Hochreiter","sequence":"first","affiliation":[{"name":"aDivision of Hospital Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Sullivan","sequence":"additional","affiliation":[{"name":"bSeattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M.","family":"DeLaroche","sequence":"additional","affiliation":[{"name":"cDivision of Pediatric Emergency Medicine, Department of Pediatrics, Children\u2019s Hospital of Michigan, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shobhit","family":"Jain","sequence":"additional","affiliation":[{"name":"dDivision of Emergency Medicine, Department of Pediatrics, Children\u2019s Healthcare of Atlanta, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel L.","family":"Knochel","sequence":"additional","affiliation":[{"name":"eDivision of Pediatric Hospital Medicine, University of Utah and Primary Children\u2019s Hospital, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Kim","sequence":"additional","affiliation":[{"name":"fDivision of Pediatric Hospital Medicine, Department of Pediatrics, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark I.","family":"Neuman","sequence":"additional","affiliation":[{"name":"gDivision of Emergency Medicine, Department of Pediatrics, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie K.","family":"Prusakowski","sequence":"additional","affiliation":[{"name":"hDepartments of Emergency Medicine and Pediatrics, Carilion Clinic, Roanoke, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvyn","family":"Braiman","sequence":"additional","affiliation":[{"name":"iSUNY Downstate Health Sciences University, Department of Pediatrics, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Y.","family":"Colgan","sequence":"additional","affiliation":[{"name":"jDivision of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison Y.","family":"Payson","sequence":"additional","affiliation":[{"name":"kDivision of Pediatric Hospital Medicine, Department of Pediatrics, Cohen Children's Medical Center-Northwell Health and Zucker School of Medicine at Hofstra\/Northwell, Hofstra University, New Hyde Park, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel S.","family":"Tieder","sequence":"additional","affiliation":[{"name":"lDivision of Hospital Medicine, Department of Pediatrics, Seattle Children\u2019s and the University of Washington School of Medicine, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Brief Resolved Unexplained Event Research and Quality Improvement 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