for people ages 18 years and up (full criteria)
Healthy Volunteers
healthy people welcome
at San Francisco, California and other locations
study started
completion around



This study will compare two strategies that target distinct determinants of blood culture overuse in an exploratory, hybrid, pilot trial in 8 PICUs. It aims to determine if there is any association between specific strategies used to reduce blood culture overuse on unit-wide blood culture rates, patient safety, and concurrently explore aspects of the implementation process (acceptability, feasibility, appropriateness).


Blood cultures are an important test to diagnose bacterial bloodstream infections, but can be ordered reflexively, excessively, and lead to downstream negative patient consequences such as unnecessary antibiotic exposure. Work to date has demonstrated safe and effective reduction in blood culture rates in the pediatric intensive care unit (PICU) setting, but optimal strategies to reduce culture use are currently unknown.

The primary study team will initially work with all enrolled sites in an identical fashion, facilitating a core series of steps for implementing a quality improvement blood culture diagnostic stewardship program which is identical to the steps used in the parent study, called BrighT STAR (Testing STewardship to reduce Antibiotic use and Resistance). In addition, the primary study team will randomize sites into two arms, in which different strategies are introduced that each target distinct determinants of blood culture overuse. The primary study team will examine the impact on blood culture rates, as well as evaluate aspects of the implementation process, in all sites pre- vs-post intervention.


Blood Culture Rates, Antibiotic Stewardship, Implementation Science, blood culture, implementation, Checklist, Targeted Messaging, Default Bias, Loss Aversion


You can join if…

Open to people ages 18 years and up

  • Males or females over 18 years old
  • PICU clinicians with direct patient care roles

You CAN'T join if...

  • Non-English speaking
  • PICU clinicians who report to the investigator


  • UCSF Benioff Children's Hospital Mission Bay
    San Francisco California 94158 United States
  • UCLA Mattel Children's Hospital
    Los Angeles California 90095 United States


accepting new patients by invitation only
Start Date
Completion Date
Children's Hospital of Philadelphia
Study Type
Expecting 8 study participants
Last Updated