We thank Drs Quinonez and Garber for their thoughtful comments on our recent manuscript and appreciate the opportunity to further clarify our work. We agree that those embarking on improvement projects should consider value. The improvement project described in this article1 is part of a larger institutional portfolio of improvement work centered on patients admitted with acute lower respiratory tract infections (LRTIs). Identification of the etiology of acute LRTIs is challenging. Most cases are viral,2 yet most children diagnosed with pneumonia receive antibiotics. Our efforts to increase the proportion of children with suspected bacterial pneumonia who had blood cultures performed were not conducted in isolation but rather carried out as 1 part of this larger portfolio of work. Related projects at our institution have included reducing resource utilization, such as by using narrow- rather than broad-spectrum antibiotics, in children with pneumonia,3 minimizing pulse oximetry in children with...
Conflict of Interest:None declared
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Eileen Murtagh Kurowski, Samir S. Shah, Joanna Thomson, Angela Statile, Srikant Iyer, Christine White, Lilliam Ambroggio; Author’s Response. Pediatrics August 2015; 136 (2): e549–e550. 10.1542/peds.2015-1549B
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