for people ages 18 years and up (full criteria)
healthy people welcome
at San Francisco, California
study started
estimated completion
Sunitha V Kaiser, MD MSc



Background: Asthma affects nearly 10% of American children, and is a leading cause of pediatric emergency visits and hospitalizations. Clinical pathways are operational versions of practice guidelines aimed at the hospital management of common illnesses. Single-site studies of pediatric asthma pathways have shown significant improvements in quality of care. Primary Objective: To evaluate the effectiveness of clinical pathways for improving quality of care for children with asthma in a diverse, national sample of emergency department (ED) and hospital settings. Primary Endpoints: 1. Emergency Department: The proportion of eligible children who receive systemic steroids within 60 minutes of ED arrival 2. Inpatient/Hospital: Mean length of hospital stay Study Design: This project will be implemented through an established quality improvement collaborative of hospitals across the United States, the Value in Inpatient Pediatrics Network (part of the American Academy of Pediatrics). A cluster randomized design will be employed. Group 1 hospitals will receive a multifaceted implementation strategy that includes: 1) a pathway implementation toolkit, 2) local multidisciplinary champions in the ED and inpatient settings, 3) audit and feedback, 4) educational seminars, and 5) practice facilitation (via teleconference). Group 2 will receive the same intervention with the addition of a mobile app pathway tool.

Official Title

The PIPA Study (Pathways for Improving Pediatric Asthma Care): A Cluster Randomized Trial


Asthma PIPA Intervention Bundle 1 PIPA Intervention Bundle 2


For people ages 18 years and up

Participant/Local champion Eligibility Criteria:

Inclusion Criteria:

  • Working as a physician at the study site

Exclusion Criteria:

  • None

Patient/child eligibility criteria:

Inclusion Criteria:

  • Age 2-17 years
  • Primary diagnosis of asthma

Exclusion Criteria:

  • Transferred in from another inpatient facility
  • Presence of a chronic medical condition that precludes pathway use


  • University of California
    San Francisco California 94158 United States

Lead Scientist

  • Sunitha V Kaiser, MD MSc
    Dr. Kaiser's goal is to improve quality of care for hospitalized children by accelerating use of evidence-based guidelines in clinical practice. She is currently supported by a Career Development Award from the Agency for Healthcare Research and Quality.


in progress, not accepting new patients
Start Date
Completion Date
University of California, San Francisco
Study Type
Last Updated