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https://www.readbyqxmd.com/read/29471849/implementing-alcohol-misuse-sbirt-in-a-national-cohort-of-pediatric-trauma-centers-a-type-iii-hybrid-effectiveness-implementation-trial
#1
Michael J Mello, Sara J Becker, Julie Bromberg, Janette Baird, Mark R Zonfrillo, Anthony Spirito
BACKGROUND: The American College of Surgeons mandates universal screening for alcohol misuse and delivery of an intervention for those screening positive as a requirement for certification as a level 1 trauma center. Though this requirement has been mandated for over a decade, its implementation has been challenging. Our research team completed an implementation study supporting seven pediatric trauma centers' compliance with the requirement by developing and implementing an institutional alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) policy for adolescent trauma patients...
February 22, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29471817/health-care-quality-measures-for-children-and-adolescents-in-foster-care-feasibility-testing-in-electronic-records
#2
Katherine J Deans, Peter C Minneci, Kristine M Nacion, Karen Leonhart, Jennifer N Cooper, Sarah Hudson Scholle, Kelly J Kelleher
BACKGROUND: Preventive quality measures for the foster care population are largely untested. The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. METHODS: The AAP Recommendations for Preventive Pediatric Health Care served as the guideline for determining quality measures...
February 22, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29452576/assessing-retention-in-care-after-12-months-of-the-pediatric-development-clinic-implementation-in-rural-rwanda-a-retrospective-cohort-study
#3
Scheilla Bayitondere, Francois Biziyaremye, Catherine M Kirk, Hema Magge, Katrina Hann, Kim Wilson, Christine Mutaganzwa, Eric Ngabireyimana, Fulgence Nkikabahizi, Evelyne Shema, David B Tugizimana, Ann C Miller
BACKGROUND: In Africa, a high proportion of children are at risk for developmental delay. Early interventions are known to improve outcomes, but they are not routinely available. The Rwandan Ministry of Health with Partners In Health/Inshuti Mu Buzima created the Pediatric Development Clinic (PDC) model for providing interdisciplinary developmental care for high-risk infants in rural settings. As retention for chronic care has proven challenging in many settings, this study assesses factors related to retention to care after 12 months of clinic enrollment...
February 16, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29422435/the-catch-to-confidentiality-the-use-of-electronic-health-records-in-adolescent-health-care
#4
Timothy Stablein, Keith J Loud, Christopher DiCapua, Denise L Anthony
PURPOSE: This study aims to understand pediatric health-care providers' expectations and the practices they employ to protect confidentiality in electronic health records (EHRs) and subsequently how EHRs affect the documentation and dissemination of information in the course of health-care delivery to adolescent minors. METHODS: Twenty-six pediatric health-care providers participated in in-depth interviews about their experiences using EHRs to understand a broad spectrum of expectations and practices guiding the documentation and dissemination of information in the EHR...
February 6, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29419821/the-use-of-individual-provider-performance-reports-by-us-hospitals
#5
Joshua A Rolnick, Kira L Ryskina
Medicare reimbursement for hospitals is increasingly tied to performance. The use of individual provider performance reports offers the potential to improve clinical outcomes through social comparison, and isolated cases of clinical dashboard uses at specific institutions have been previously reported. However, little is known about overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. We used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles...
February 7, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29408736/diagnostic-evaluation-comorbidity-screening-and-treatment-of-polycystic-ovary-syndrome-in-adolescents-in-three-specialty-clinics
#6
Meghna R Sebastian, Constance M Wiemann, Fida Bacha, Sharonda J Alston-Taylor
STUDY OBJECTIVE: A polycystic ovary syndrome (PCOS) diagnosis in adolescence can have significant long-term health implications. The criteria for its diagnosis in adolescents have been subject to much debate. This study aimed to characterize the variability in diagnosis and management among different pediatric specialties. DESIGN, SETTINGS, PARTICIPANTS, AND INTERVENTIONS: This is a retrospective review of electronic medical records of females (11 - 21 years old) who presented to three specialties (adolescent medicine (AM), pediatric endocrinology (ENDO), and gynecology (GYN)), with a post-visit diagnosis of PCOS, menstrual disorders, or hirsutism, at a large tertiary care center, from November 1, 2011- October 31, 2012...
January 31, 2018: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29400622/a-retrospective-analysis-of-boarding-times-for-adolescents-in-psychiatric-crisis
#7
Michael Campbell, Jessica Pierce
The boarding of children and adolescents with identified psychiatric conditions at medical facilities has numerous negative effects on the patients and the systems that treat them. Efforts to minimize boarding times serves to increase patients' access to appropriate levels of care, redirect medical resources to patients who need them most, and reduce safety risks to people and property. This study explores the role Clinical Social Workers can play in facilitation of care and highlights the advantages of a coordinated data collection process facilitated by the effective use of the Electronic Medical Record...
February 5, 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29398316/nurse-led-discharge-in-pediatric-care-a-scoping-review
#8
REVIEW
Sydney Breneol, Aaron Hatty, Andrea Bishop, Janet A Curran
PROBLEM: Patients and caregivers frequently report feeling ill-prepared during the transition from hospital to home. Given the privileged position nurses occupy within the health care setting, they are often an appropriate health care professional to lead the discharge process. We aimed to map what is currently known about nurse-led/facilitated discharge programs, interventions, models, or frameworks for the pediatric population. ELIGIBILITY CRITERIA: We conducted a scoping review following the Joanna Briggs Institute Methodology...
February 1, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29396080/pediatrician-and-behavioral-clinician-delivered-screening-brief-intervention-and-referral-to-treatment-substance-use-and-depression-outcomes
#9
Stacy Sterling, Andrea H Kline-Simon, Constance Weisner, Ashley Jones, Derek D Satre
PURPOSE: Early intervention for adolescent substance use and mental health problems may mitigate potential harm. We examined patient outcomes from a pragmatic trial of two modalities of delivering screening, brief intervention, and referral to treatment (SBIRT) and usual care (UC) in pediatric primary care. METHODS: All clinic pediatricians (n = 52) were randomized to three arms: (1) pediatrician-only, in which pediatricians were trained to deliver SBIRT; (2) embedded behavioral clinician (BC), in which pediatricians were trained to refer eligible adolescents to a BC who administered SBIRT; and (3) UC...
January 23, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29395791/use-of-electronic-visibility-boards-to-improve-patient-care-quality-safety-and-flow-on-inpatient-pediatric-acute-care-units
#10
Mary Field, Krista Fong, Carol Shade
PURPOSE: Effective information exchange among healthcare providers is critical to the delivery of high quality care. Electronic visibility boards (EVB) are an established tool for improving health care efficiency and promoting communication between healthcare team members. DESIGN AND METHODS: Seattle Children's Hospital (SCH) sought to evaluate the use of EVBs as a tool to improve patient care quality, safety and flow in a pediatric inpatient setting. EVBs were placed on the cancer and surgical patient care units at SCH, and displayed data flowing directly from the electronic health record...
January 30, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29394479/quality-improvement-initiative-on-pain-knowledge-assessment-and-documentation-skills-of-pediatric-nurses
#11
Heather Margonary, Margaret S Hannan, Elizabeth A Schlenk
Pain treatment begins with a nurse’s assessment, which relies on effective assessment skills. Hospital settings have implemented pain assessment education, but there is limited evidence in pediatric transitional care settings. The purpose of this quality improvement (QI) initiative was to develop, implement, and evaluate an evidence-based pain education session with 20 nurses in a pediatric specialty hospital that provides transitional care. Specific aims were to assess nurses’ knowledge and attitudes of pain, and evaluate assessment skills based on nurses’ documentation...
March 2017: Pediatric Nursing
https://www.readbyqxmd.com/read/29385988/a-patient-and-family-data-domain-collection-framework-for-identifying-disparities-in-pediatrics-results-from-the-pediatric-health-equity-collaborative
#12
Aswita Tan-McGrory, Caroline Bennett-AbuAyyash, Stephanie Gee, Kirk Dabney, John D Cowden, Laura Williams, Sarah Rafton, Arie Nettles, Sonia Pagura, Laurens Holmes, Jane Goleman, LaVone Caldwell, James Page, Patricia Oceanic, Erika J McMullen, Adriana Lopera, Sarah Beiter, Lenny López
BACKGROUND: By 2020, the child population is projected to have more racial and ethnic minorities make up the majority of the populations and health care organizations will need to have a system in place that collects accurate and reliable demographic data in order to monitor disparities. The goals of this group were to establish sample practices, approaches and lessons learned with regard to race, ethnicity, language, and other demographic data collection in pediatric care setting. METHODS: A panel of 16 research and clinical professional experts working in 10 pediatric care delivery systems in the US and Canada convened twice in person for 3-day consensus development meetings and met multiple times via conference calls over a two year period...
January 31, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29378579/provider-views-on-childhood-obesity-management-in-primary-care-settings-a-mixed-methods-analysis
#13
Kyung E Rhee, Stephanie Kessl, Sarah Lindback, Marshall Littman, Robert E El-Kareh
BACKGROUND: Pediatric providers are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. The goal of this study was to examine the views of pediatric providers on conducting obesity management in the primary care setting, and identify potential resources and care models that could facilitate delivery of this care. METHODS: A mixed methods approach was utilized. Four focus groups were conducted with providers from a large pediatric network in San Diego County...
January 30, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29346231/the-complex-association-of-race-ethnicity-with-pain-treatment-quality-in-an-urban-medical-center-with-2-pediatric-emergency-departments
#14
Erika M Kipping, James M Chamberlain
OBJECTIVE: This study aimed to explore racial differences in analgesia quality. METHODS: A retrospective cross-sectional study of 24,733 visits by individuals 21 years or younger with pain scores of 4 to 10 was performed using electronic medical records. We compared 2 process metrics, treatment with any analgesics within 60 minutes and treatment with opioids within 60 minutes, and one outcome metric, a reduction in pain score by 2 or more points within 90 minutes...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#15
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND:  Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE:  We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29334983/an-individually-tailored-family-centered-intervention-for-pediatric-obesity-in-primary-care-study-protocol-of-a-randomized-type-ii-hybrid-effectiveness-implementation-trial-raising-healthy-children-study
#16
Justin D Smith, Cady Berkel, Neil Jordan, David C Atkins, Shrikanth S Narayanan, Carlos Gallo, Kevin J Grimm, Thomas J Dishion, Anne M Mauricio, Jenna Rudo-Stern, Mariah K Meachum, Emily Winslow, Meg M Bruening
BACKGROUND: Pediatric obesity is a multi-faceted public health concern that can lead to cardiovascular diseases, cancers, and early mortality. Small changes in diet, physical activity, or BMI can significantly reduce the possibility of developing cardiometabolic risk factors. Family-based behavioral interventions are an underutilized, evidence-based approach that have been found to significantly prevent excess weight gain and obesity in children and adolescents. Poor program availability, low participation rates, and non-adherence are noted barriers to positive outcomes...
January 15, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29325519/providers-preferences-for-pediatric-oral-health-information-in-the-electronic-health-record-a-cross-sectional-survey
#17
Christopher M Shea, Kea Turner, B Alex White, Ye Zhu, R Gary Rozier
BACKGROUND: The majority of primary care physicians support integration of children's oral health promotion and disease prevention into their practices but can experience challenges integrating oral health services into their workflow. Most electronic health records (EHRs) in primary care settings do not include oral health information for pediatric patients. Therefore, it is important to understand providers' preferences for oral health information within the EHR. The objectives of this study are to assess (1) the relative importance of various elements of pediatric oral health information for primary care providers to have in the EHR and (2) the extent to which practice and provider characteristics are associated with these information preferences...
January 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29315417/interactive-or-static-reports-to-guide-clinical-interpretation-of-cancer-genomics
#18
Stacy W Gray, Jeffrey Gagan, Ethan Cerami, Angel M Cronin, Hajime Uno, Nelly Oliver, Carol Lowenstein, Ruth Lederman, Anna Revette, Aaron Suarez, Charlotte Lee, Jordan Bryan, Lynette Sholl, Eliezer M Van Allen
Objective: Misinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. We sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation. Materials and Methods: We conducted a randomized, vignette-based survey study to determine whether exposure to interactive reports for a somatic gene panel, as compared to static reports, improves physicians' genomic comprehension and report-related satisfaction (overall scores calculated across 3 vignettes, range 0-18 and 1-4, respectively, higher score corresponding with improved endpoints)...
January 5, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29310768/sjs-ten-2017-building-multidisciplinary-networks-to-drive-science-and-translation
#19
REVIEW
Katie D White, Riichiro Abe, Michael Ardern-Jones, Thomas Beachkofsky, Charles Bouchard, Bruce Carleton, James Chodosh, Ricardo Cibotti, Robert Davis, Joshua C Denny, Roni P Dodiuk-Gad, Elizabeth N Ergen, Jennifer L Goldman, James H Holmes, Shuen-Iu Hung, Mario E Lacouture, Rannakoe J Lehloenya, Simon Mallal, Teri A Manolio, Robert G Micheletti, Caroline M Mitchell, Maja Mockenhaupt, David A Ostrov, Rebecca Pavlos, Munir Pirmohamed, Elena Pope, Alec Redwood, Misha Rosenbach, Michael D Rosenblum, Jean-Claude Roujeau, Arturo P Saavedra, Hajirah N Saeed, Jeffery P Struewing, Hirohiko Sueki, Chonlaphat Sukasem, Cynthia Sung, Jason A Trubiano, Jessica Weintraub, Lisa M Wheatley, Kristina B Williams, Brandon Worley, Wen-Hung Chung, Neil H Shear, Elizabeth J Phillips
Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a life-threatening, immunologically mediated, and usually drug-induced disease with a high burden to individuals, their families, and society with an annual incidence of 1 to 5 per 1,000,000. To effect significant reduction in short- and long-term morbidity and mortality, and advance clinical care and research, coordination of multiple medical, surgical, behavioral, and basic scientific disciplines is required. On March 2, 2017, an investigator-driven meeting was held immediately before the American Academy of Dermatology Annual meeting for the central purpose of assembling, for the first time in the United States, clinicians and scientists from multiple disciplines involved in SJS/TEN clinical care and basic science research...
January 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29301735/integrating-patient-centered-electronic-health-record-communication-training-into-resident-onboarding-curriculum-development-and-post-implementation-survey-among-housestaff
#20
Maria Alcocer Alkureishi, Wei Wei Lee, Sandra Webb, Vineet Arora
BACKGROUND: Electronic health record (EHR) use can enhance or undermine the ability of providers to deliver effective, humanistic patient-centered care. Given patient-centered care has been found to positively impact patient health outcomes, it is critical to provide formal education on patient-centered EHR communication skills. Unfortunately, despite increasing worldwide EHR adoption, few institutions educate trainees on EHR communication best practices. OBJECTIVE: The goal of this research was to develop and deliver mandatory patient-centered EHR training to all incoming housestaff at the University of Chicago...
January 4, 2018: JMIR Medical Education
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