Hospital pediatrics
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Hospital pediatrics · Jun 2015
The practice patterns of recently graduated internal medicine-pediatric hospitalists.
To identify the current practice patterns and professional activities of internal medicine-pediatrics (med-peds) hospitalists who have graduated in the past 5 years (June 2009-June 2013). ⋯ An increasing percentage of recent med-peds graduates are pursuing careers in HM, and two-thirds are providing care to hospitalized children. As consideration for an accredited pediatric HM fellowship continues, certifying and accrediting bodies should consider how this will impact the med-peds workforce and allow med-peds graduates flexibility in their training requirements that will permit them to acquire the necessary skills to care for hospitalized children and adults.
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Hospital pediatrics · May 2015
Observational StudyPostdischarge phone calls after pediatric hospitalization: an observational study.
Difficulties with transition from inpatient to outpatient care can lead to suboptimal outcomes for patients. We implemented a protocol for systematic follow-up phone calls to families of pediatric patients after discharge, primarily to improve care transition. We also hypothesized that the phone calls would decrease readmissions and emergency department (ED) visits after discharge and improve patient satisfaction. ⋯ Standardized, physician-performed, postdischarge phone calls identified frequent patient care issues related to difficulties with inpatient to outpatient transition, many of which were medication related. However, our study was underpowered to detect a statistically significant correlation with changes in readmission rates, ED visits, or patient satisfaction.
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Hospital pediatrics · May 2015
Association Between Implementation of a Cardiovascular Step-Down Unit and Process-of-Care Outcomes in Patients With Congenital Heart Disease.
The Joint Commission's 2009 National Patient Safety Goals aimed to improve identification of and response to clinical deterioration in hospital-ward patients. Some hospitals implemented intermediate-care units for patients without intensive care-level support needs. No studies have evaluated what effect changes associated with a move to a pediatric cardiovascular step-down unit (CVSDU) has on process-of-care outcomes. ⋯ Changes associated with a new CVSDU were associated with decreased LOS and lower rates of rapid response and code blue events for patients with congenital heart disease.
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Hospital pediatrics · Apr 2015
Observational StudyVariation in the use of procedural sedation for incision and drainage of skin and soft tissue infection in pediatric emergency departments.
Little is known about procedural sedation use for anxiety and pain associated with skin and soft tissue infections (SSTIs) requiring incision and drainage (I&D). Our objectives were therefore (1) to characterize the use of procedural sedation use for SSTI I&D procedures in pediatric emergency departments (EDs), (2) to compare the frequency of procedural sedation for I&D across hospitals, and (3) to determine factors associated with use of procedural sedation for I&D. ⋯ Use of procedural sedation for SSTI I&D varies widely across pediatric EDs, and the majority of variation is independent of demographic differences. Additional work is needed to understand decision-making and to standardize delivery of procedural sedation in children requiring I&D.
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Hospital pediatrics · Apr 2015
ReviewThe effectiveness of family-centered transition processes from hospital settings to home: a review of the literature.
The quality of care transitions is of growing concern because of a high incidence of postdischarge adverse events, poor communication with patients, and inadequate information transfer between providers. The objective of this study was to conduct a targeted literature review of studies examining the effectiveness of family-centered transition processes from hospital- and emergency department (ED)-to-home for improving patient health outcomes and health care utilization. ⋯ Patient-tailored discharge education is associated with improved patient health outcomes in pediatric ED patients. Effective transition processes identified in the adult literature may inform future quality improvement research regarding pediatric hospital-to-home transitions.