Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Serious Illness Conversations (SICs) are not consistently integrated into existing inpatient workflows. ⋯ The lack of significant change in standardized SIC documentation may be attributed to insufficient or ineffective interventions and COVID-19-related challenges. Although patient identification is a known barrier to SICs, this issue was minimized with the use of the QSD and RRS. Further research is needed to enhance the implementation of SICs in inpatient settings.
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Airway clearance therapies (ACT) are often used to optimize respiratory function for children with neurologic impairment (CNI) hospitalized with acute respiratory infections (ARI). In a five-center retrospective cohort study of CNI aged 1-18 years hospitalized between 2013 and 2015 with ARI, we assessed the association of admission ACT with hospital outcomes (days to return to baseline respiratory support and length of stay [LOS]). ⋯ In adjusted analyses, children receiving admission ACT required similar time to return to respiratory baseline (adjusted risk ratio [aRR] 1.24, 95%CI: 0.95,1.62) and had similar LOS (aRR 1.08, 95%CI: 0.88,1.32) compared with children not receiving ACT. Future studies should seek to identify subpopulations of CNI who benefit most from ACT.
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Patients who first meet clinical criteria for sepsis while boarding in the emergency department (ED) may not receive optimal sepsis care. ⋯ Sepsis patients experiencing T-0 as a boarder in the ED have a lower likelihood of receiving SEP-1 compliant care compared to patients who experience T-0 while still under ED care.
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This study describes United States (US) pediatric hospitals' compliance with the Centers for Medicare and Medicaid price transparency rule. The price transparency rule was intended to make healthcare costs more transparent for patients and families to aid in informed decisions and help avoid unexpected charges. The price transparency rule consists of two parts: (1) a standard charge file, and (2) "shoppable services." Using hospital websites accessed through the Children's Hospital Association during January and February 2023, we found that only 48.7% of US pediatric hospitals were fully compliant with all required components despite implementation of this rule nearly 3 years ago.