Academic pediatrics
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Academic pediatrics · Sep 2015
Structure and Function of Observation Units in Children's Hospitals: A Mixed-Methods Study.
Observation unit (OU) use has been promoted recently to decrease resource utilization and costs for select patients, but little is known about the operations of pediatric OUs. This study aimed to characterize the infrastructure and function of OUs within freestanding children's hospitals and to compare characteristics between hospitals with and without OUs. ⋯ OUs were located in higher volume hospitals and varied by location, size, and staffing. Most functioned as hybrid OUs. OUs based admissions on intuition, had staffing cultures centered on rapid turnover of patient care, lacked consistent outcome measures, and faced challenges regarding utilization review and patient copayments.
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Academic pediatrics · Sep 2015
Trends in Unmet Need for Genetic Counseling Among Children With Special Health Care Needs, 2001-2010.
Access to genetic counseling is increasingly important to guide families' and clinicians' decision making, yet there is limited research on accessibility and affordability of counseling for families with children with special health care needs (CSHCN). Our study's objectives were to measure changes in unmet need for genetic counseling for CSHCN from 2001 to 2010 and to characterize child, family, and health system factors associated with unmet need. ⋯ Unmet need for genetic counseling has increased over the past 12 years. Uninsurance and financial problems related to health care costs were the largest drivers of unmet need over time.
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Academic pediatrics · Jul 2015
Resident Self-Assessment and Learning Goal Development: Evaluation of Resident-Reported Competence and Future Goals.
To determine incidence of learning goals by competency area and to assess which goals fall into competency areas with lower self-assessment scores. ⋯ Senior residents appear to develop better skills and/or motivation to explicitly turn self-assessed learning gaps into learning goals, suggesting that individualized learning plans may help improve self-regulated learning during residency.
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Academic pediatrics · Jul 2015
Professionalism and Communication Education in Pediatric Critical Care Medicine: The Learner Perspective.
Communication and professionalism are often challenging to teach, and the impact of the use of a given approach is not known. We undertook this investigation to establish pediatric critical care medicine (PCCM) trainee perception of education in professionalism and communication and to compare their responses from those obtained from PCCM fellowship program directors. ⋯ There are numerous components of communication and professionalism that PCCM fellows perceive as not being specifically taught. Despite these deficiencies, fellow confidence remains high. Substantial opportunities exist to improve teaching in these areas.
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Academic pediatrics · Jul 2015
Assuring Adequate Health Insurance for Children With Special Health Care Needs: Progress From 2001 to 2009-2010.
To report on coverage and adequacy of health insurance for children with special health care needs (CSHCN) in 2009-2010 and assess changes since 2001. ⋯ There has been a continued shift from private to public coverage, which is more affordable, offers benefits that are more likely to meet CSHCN needs, and allowed CSHCN to see necessary providers.