Best Practice Collaborative
Advancing Pediatric Clinical Pathways Through Collaboration
The Pathways4Kids Best Practice Collaborative brings together multidisciplinary leaders from children’s hospitals across North America to identify shared challenges, develop evidence informed resources, and advance best practices for pediatric clinical pathways. Through collaborative projects, our members are working to improve measurement, build consensus, and support more consistent, high quality care for children.
Pathways4Kids Publications
The work of the Best Practice Collaborative builds upon previously published research that explored the current landscape of pediatric clinical pathway programs and highlighted the need for greater collaboration across institutions. If you’d like your article added to this list, reach out to Courtney Titus or Tara Dinh.
Clinical Pathways Programs in Children’s Hospitals
Leigh Anne Bakel, Ilana Y. Waynik, Amy J. Starmer, Adam K. Berkwitt, Sonja I. Ziniel. Pediatrics. 2024.
- Authored by our Chair, Leigh Anne Bakel, MD, MSc, and Vice Chair, Ilana Waynik, MD and other Pathways4kids members, this national study examined pediatric clinical pathway programs across children’s hospitals. The findings highlighted shared challenges, opportunities for standardized measurement, and strong interest in cross institutional collaboration, helping establish the vision for Pathways4Kids.
Continuous Aerosolized Albuterol Treatment for Status Asthmaticus on the General Care Floor: A Quality Improvement Initiative
Kailey A. Remien, Charles Hardy, Karen Allen, Matthew Wysong, Morgan Zlotolow, Gerd McGwire, Courtney Whitacre, Renae Forsythe, Tara Dinh, Lisa Ulrich, Adjoa A. Andoh, Samantha W. Gee, Shauna Schord. Pediatric Quality & Safety. 2026.
- Authored by Nationwide Children’s Hospital, this quality improvement project tested whether continuous aerosolized albuterol (CAA), usually given in the PICU or ED, could be safely used on the general care floor (GCF) for children aged 2–18 years with status asthmaticus using a structured protocol, staff education, electronic health record changes, and a resident-led handoff huddle.
Current Collaborative Projects
Respiratory Standard Measures
Project Leads
- Kelsey Zindel, DNP, APRN-NP, Children’s Nebraska
- Leigh Anne Bakel, MD, MSc, Colorado Children’s Hospital
Objective
- Develop a standardized set of quality measures for pediatric respiratory pathways that can support quality improvement and future benchmarking across institutions.
Current Work
- Identifying core measures
- Standardizing measure definitions
Sites Included:
- Children’s Nebraska
- Colorado Children’s Hospital
- Nicklaus Health
- Children’s National
- Children’s Hospital of Pittsburgh
- Arkansas Children’s
- Boston Children’s
- Texas Children’s
- Seattle Children’s
Site Enrollment Status: Group is not currently enrolling new sites for the initial phase but will in the future. If you are interested in participating in the second phase, please contact the project leads to express your interest and receive updates on future enrollment opportunities.
Febrile Infant Standard Measures
Project Leads
- Courtney Titus, MPAS, PA C, Johns Hopkins All Children’s Hospital
- Leigh Anne Bakel, MD, MSc, Colorado Children’s Hospital
- Kelsey Zindel, DNP, APRN-NP, Children’s Nebraska
Objective
- Develop standardized quality measures for pediatric febrile infant pathways who utilize AgileMD guidelines
- Improve consistency in measurement and facilitate collaborative learning.
Current Work:
- Identifying core measures
- Developing measure specifications
- Pilot 3 site IRB Submissions
- Other sites will be added in the future
- Benchmarking across participating organizations
Sites Included:
- Children’s Nebraska
- Johns Hopkins All Children’s Hospital
- Johns Hopkins Hospital
- Colorado Children’s Hospital
- Arkansas Children’s
- Yale New Haven Hospital
- The Medical University of South Carolina
- Vanderbilt University Medical Center
- St. Jude Children’s Research Hospital
- University of California, San Francisco
- John Muir Health
- University of Chicago
- University of Wisconsin
- Advocate Aurora Health
Site Enrollment Status: Group is not currently enrolling new sites for the initial phase but will in the future. If you are interested in participating in the second phase, please contact the project leads to express your interest and receive updates on future enrollment opportunities.
Delphi Consensus Study
Project Leads
- Ilana Waynik, MD, Connecticut Children’s Hospital
- Leigh Anne Bakel, MD, MSc, Colorado Children’s Hospital
- Sarah Marzec, MA, MD, Nationwide Children’s Hospital
Objective
- Use a structured Delphi methodology to develop national expert consensus on pediatric clinical pathway program best practices.
Current Work
- Developing study specifications
Site Enrollment Status: Group is not currently enrolling new sites for the initial phase of work.
Looking Ahead
As Pathways4Kids continues to grow, additional collaborative projects will be launched to address emerging priorities in pediatric clinical pathways, implementation science, benchmarking, and quality improvement.