NCT05132322

Eliminating Monitor Overuse Trial (EMO Trial)

Eliminating Monitor Overuse (EMO) Hybrid Effectiveness-Deimplementation Trial

• Status: Active Not Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 9,265 (actual)
• Sponsor: Children's Hospital of Philadelphia · Academic / Other
• Sex: All
• Age: 2 Months
• Healthy volunteers: Not accepted

Summary

The purpose of this study is to identify the optimal deimplementation strategies for an overused practice: continuous pulse oximetry monitoring of children hospitalized with bronchiolitis who are not receiving supplemental oxygen.

Conditions

• Bronchiolitis Acute Viral

Interventions

Type	Name	Description
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.

Timeline

• Start date: 2021-12-01
• Primary completion: 2024-03-31
• Completion: 2026-08-01
• First posted: 2021-11-24
• Last updated: 2026-02-13
• Results posted: 2026-02-13

Locations

51 sites across 2 countries: United States, Canada