Vancomycin is a strong antibiotic often used in children's hospitals. However, using it too much can cause kidney problems in about 25% of cases. This study aims to reduce unnecessary vancomycin use in five Pediatric Intensive Care Units (PICUs) by creating guidelines to help doctors know when to use it. They will look at vancomycin usage data from Electronic Health Records (EHR) over two years and educate doctors on proper use. The study involves two groups: PICU doctors and children admitted to these units during the study.

The study will last for about 24 months, and researchers will measure how much vancomycin is used. There will also be interviews and surveys with doctors to find out what parts of the study worked well. This study is important because it can help keep kids safer by reducing unnecessary use of strong antibiotics.

• Study duration is approximately 24 months.
• No patients are excluded; all admitted to PICUs can participate.
• Doctors will receive special guidelines and feedback on vancomycin use.