Hospital pediatrics
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Hospital pediatrics · Jan 2012
Hospitalist and nonhospitalist adherence to evidence-based quality metrics for bronchiolitis.
Hospitalists are a new subgroup of pediatricians. However, data comparing quality of care between hospitalists and nonhospitalists are limited. Bronchiolitis, a common cause of pediatric hospital admission, is an appropriate condition for evaluating inpatient quality of care. The goal of this study was to identify quality indicators for the evaluation and treatment of children hospitalized with bronchiolitis based on the 2006 American Academy of Pediatrics guidelines and to assess differences in adherence rates to these indicators between hospitalist and nonhospitalist pediatricians. ⋯ These data suggest hospitalists better adhere to selected portions of the American Academy of Pediatrics bronchiolitis guidelines, thus providing higher quality of care. Quality indicators used in this study can distinguish physician performance in the inpatient management of bronchiolitis.
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Hospital pediatrics · Jan 2012
Traditional measures of hospital utilization may not accurately reflect dynamic patient demand: findings from a children's hospital.
Hospital crowding adversely affects access to emergent and elective care, quality and safety, patient and staff satisfaction, and trainee education. Reliable and valid measurements are crucial to operational planning and improvement, but traditional measures of hospital utilization may not accurately describe dynamic demand at hospitals. The goal of this study was to determine how effectively traditional measures express demand for hospital services and to describe the dynamic nature of patient flow in children's hospitals compared with alternative measures. ⋯ Traditional metrics for hospital utilization do not accurately express the true extent and dynamic nature of patient flow and inpatient demand at a children's hospital. Hospitals and government regulatory agencies should consider additional means of measuring utilization to accurately determine demand, including its variation, and thus assist in budgeting, staffing, and capacity planning.
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Hospital pediatrics · Jan 2012
Perceptions of physician bedside handoff with nurse and family involvement.
Physician-to-physician handoffs have been identified as a high-risk area of patient care. Few data exist to support any specific handoff process as being superior. We developed a handoff process entitled physician bedside handoff (PBH), which is unique for allowing all stakeholders, including the parents of patients, to be involved in the handoff at the bedside. Our goal was to compare stakeholder perceptions of PBH with traditional physician handoff and to learn which factors stakeholders believe are important for improving handoffs in general. ⋯ Participants identified that including all stakeholders is essential to improve handoffs, that PBH is not superior to traditional handoffs, and that both processes have value. Further research should be conducted to determine if including all stakeholders in the handoff process results in improved quality of care and safety.