Co-design and evaluation of a regional and rural translation bronchiolitis platform: study protocol

Louise Shaw; Catherine Wilson; Meredith Borland; Elizabeth Cotterell; John Craven; Janet Curran; Stuart Dalziel; Tahnee Dunlop; Donna Franklin; Libby Haskell; Anna Lithgow; Sandy Middleton; Sharon O'Brien; Annelise Staples; Viet Tran; Franz E Babl; Emma Tavender

doi:10.1038/s41390-025-04503-1

Co-design and evaluation of a regional and rural translation bronchiolitis platform: study protocol

Pediatr Res. 2025 Nov 3. doi: 10.1038/s41390-025-04503-1. Online ahead of print.

Authors

Louise Shaw^{1

2}, Catherine Wilson³, Meredith Borland^{4

5}, Elizabeth Cotterell^{6

7}, John Craven^{8

9

10

11}, Janet Curran¹², Stuart Dalziel^{13

14}, Tahnee Dunlop¹⁵, Donna Franklin^{16

17

18}, Libby Haskell^{14

19}, Anna Lithgow²⁰, Sandy Middleton^{21

22}, Sharon O'Brien^{4

5}, Annelise Staples²³, Viet Tran^{24

25

26}, Franz E Babl^{3

27

28}, Emma Tavender^{3

28

29}

Affiliations

¹ Emergency Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia. louise.shaw@mcri.edu.au.
² Centre for Digital Transformation of Health, University of Melbourne, Melbourne, VIC, Australia. louise.shaw@mcri.edu.au.
³ Emergency Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
⁴ Emergency Department, Perth Children's Hospital, Nedlands, WA, Australia.
⁵ Divisions of Emergency Medicine and Paediatrics, School of Medicine, University of Western Australia, Crawley, WA, Australia.
⁶ Department of Paediatrics, Armidale Rural Referral Hospital, Armidale, NSW, Australia.
⁷ School of Rural Medicine, University of New England, Tablelands Clinical School, Armidale, NSW, Australia.
⁸ Emergency Department, Mount Barker District Soldiers Memorial Hospital, Mount Barker, SA, Australia.
⁹ College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
¹⁰ Faculty of Health, Charles Darwin University, Darwin, NT, Australia.
¹¹ Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
¹² School of Nursing, Dalhousie University, Halifax, NS, Canada.
¹³ Departments of Surgery and Paediatrics, The University of Auckland, Auckland Central, New Zealand.
¹⁴ Emergency Medicine Research, Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
¹⁵ Centre for Rural Emergency Medicine, Deakin University, Warrnambool, VIC, Australia.
¹⁶ Children's Emergency and Critical Care Research, Gold Coast University Hospital, Southport, QLD, Australia.
¹⁷ Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
¹⁸ College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
¹⁹ Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
²⁰ Paediatric Department, The Royal Darwin Hospital, Tiwi, NT, Australia.
²¹ Nursing Research Institute, St Vincent's Health Network, Darlinghurst, NSW, Australia.
²² School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, VIC, Australia.
²³ Bendigo Health Emergency Department, Bendigo, VIC, Australia.
²⁴ Tasmanian School of Medicine, University of Tasmania, Hobart, TAS, Australia.
²⁵ Royal Hobart Hospital, Tasmanian Health Service, Hobart, TAS, Australia.
²⁶ Tasmanian Emergency Medicine Research Institute, University of Tasmania, Hobart, TAS, Australia.
²⁷ Emergency Department, The Royal Children's Hospital Melbourne, Melbourne, VIC, Australia.
²⁸ Departments of Paediatrics and Critical Care, University of Melbourne, Melbourne, VIC, Australia.
²⁹ Faculty of Health Sciences, Australian Catholic University, East Melbourne, VIC, Australia.

PMID: 41184625
DOI: 10.1038/s41390-025-04503-1

Abstract

Background: Bronchiolitis is the leading cause of hospitalisation in infants under one year. While evidence-based guidelines exist, including the updated Australasian Bronchiolitis Guidelines (2025), variations in care persist. Improving care in regional and rural hospitals is challenging due to limited access to paediatric expertise and evidence-based resources, contributing to continued use of low-value interventions.

Methods: This mixed methods study will use a human-centred design approach to co-design and evaluate the usability of the Regional and Rural Translation Bronchiolitis (RART-Bronch) platform, an interactive online tool targeted at non-metropolitan settings. The platform will feature bronchiolitis educational resources, implementation support, a benchmarking and feedback tool, and family education materials. Participants will be regional and rural clinicians and parents of infants hospitalised with bronchiolitis in these settings. Data will be collected through co-design meetings, usability surveys, semi-structured interviews, and think aloud methods. Engagement with the co-design process will also be evaluated.

Results: We will develop a user-friendly, evidence-based platform specific to regional and rural contexts that supports bronchiolitis guideline adherence and enhances clinical decision-making.

Conclusion: Effectiveness will be evaluated in a future cluster randomised controlled trial and may inform future implementation strategies for improving care, quality and equity across regional and rural healthcare.

Impact: This study aims to reduce variation in bronchiolitis care by co-designing an interactive online platform, RART-Bronch, with clinicians and parents from regional and rural settings. The platform aims to support sustainable reductions in low-value care and improve outcomes for infants with bronchiolitis. It will deliver evidence-based guidance to clinicians working in regional and rural hospitals with limited paediatric expertise. Findings will inform future implementation of tailored education, audit and feedback strategies in acute care. This work aims to enhance paediatric care quality in under-resourced settings and contribute to scalable, equitable improvements in bronchiolitis management across Australia.