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Full-Text Articles in Medicine and Health Sciences
Get Smart: Implementation Of Updated Asthma Guidelines For Pediatric Hospitalists, Alexander Hogan, Kathryn Kyler, Claire Seguin
Get Smart: Implementation Of Updated Asthma Guidelines For Pediatric Hospitalists, Alexander Hogan, Kathryn Kyler, Claire Seguin
Presentations
Prescription of Single Maintenance And Reliever Therapy (SMART) for moderate and severe persistent asthma is the most important and actionable improvement in the National Heart Lung Blood Institute (NHLBI) asthma guidelines for pediatric hospitalists. SMART is the use of a single inhaled corticosteroid/long acting beta agonist inhaler both as a daily preventive inhaler and as-needed for asthma symptoms. As hospitalists, we treat patients with poorly controlled asthma who will benefit from SMART asthma action plans. Despite ample evidence supporting use of SMART, implementation of such large changes in practice is challenging. Implementation science and quality improvement principles can be used …
Financial Outcomes By Severity Across Children's Hospitals, Jonathan Hartley, Jessica L. Bettenhausen, Matt Hall, David C. Synhorst, Jessica L. Markham, James Gay
Financial Outcomes By Severity Across Children's Hospitals, Jonathan Hartley, Jessica L. Bettenhausen, Matt Hall, David C. Synhorst, Jessica L. Markham, James Gay
Presentations
Background: Hospitalizations represent a significant driver of healthcare costs for children. Little is known about how payor type and the severity of children cared for on the general pediatric inpatient floor impact a hospital’s financial outcomes. Objective: The primary objective of this study is to compare financial outcomes of pediatric hospitalizations to the general floor across patient severity quartiles. Secondary objectives included financial outcomes stratified by payor type across severity quartiles. Methods: Retrospective cohort study included children aged 0-18 years discharged during calendar year 2019 from hospitals that reported clinical information to the Pediatric Health Information System database and financial …
Implementation Of Longitudinal Learning Curricula Results In Improved Ite Scores And Abp Certifying Examination Pass Rates, Angela Etzenhouser, Emily Killough, Danielle Reed
Implementation Of Longitudinal Learning Curricula Results In Improved Ite Scores And Abp Certifying Examination Pass Rates, Angela Etzenhouser, Emily Killough, Danielle Reed
Presentations
OBJECTIVE: To improve In-Training Examination (ITE) Scores and American Board of Pediatrics (ABP) Certifying Examination pass rates, our program implemented two longitudinal learning curricula; the objective of this study was to evaluate the effectiveness of these curricula. BACKGROUND: In 2018, we developed the “ITE Study Plan” which requires participation for residents whose ITE score falls below the national average. Residents develop a study plan that incorporates a minimum of 10 PREP questions per week along with any additional learning modalities they wish to utilize. Progress and compliance with the study plan is monitored monthly by an Associate Program Director. In …
Rates Of Physical Abuse Screening And Detection In Infants With Brief Resolved Unexplained Events (Brues), Angela Doswell, James Anderst, Joel Tieder, Henry T. Puls, Brue Research And Quality Improvement Network
Rates Of Physical Abuse Screening And Detection In Infants With Brief Resolved Unexplained Events (Brues), Angela Doswell, James Anderst, Joel Tieder, Henry T. Puls, Brue Research And Quality Improvement Network
Presentations
Background: “Apparent Life-Threatening Events” (ALTEs) have been associated with child physical abuse (CPA). In 2016, “Brief Resolved Unexplained Event” (BRUE) and the development of its clinical guidelines and risk-stratification replaced ALTE. However, it is unknown if there is a similar association between BRUEs and CPA. Hypothesis/Objectives: To determine the rate of CPA in infants presenting with a BRUE, examine differences between infants with and without CPA, and to examine rates of diagnostic testing used to detect CPA. Methods: This study was part of the BRUE Research and Quality Improvement Network, composed of 15 hospitals. Subjects were infants presenting with BRUE …
Financial Outcomes By Severity Across Children's Hospitals, Jonathan Hartley, Jessica L. Bettenhausen, Matt Hall, James Gay, David C. Synhorst, Jessica L. Markham
Financial Outcomes By Severity Across Children's Hospitals, Jonathan Hartley, Jessica L. Bettenhausen, Matt Hall, James Gay, David C. Synhorst, Jessica L. Markham
Presentations
Background: Hospitalizations represent a significant driver of healthcare costs for children. Little is known about how payor type and the severity of children cared for on the pediatric medical inpatient floor impact a hospital’s financial outcomes. Objective: The primary objective of this study is to compare financial outcomes of pediatric hospitalizations to the medical inpatient floor across patient severity quartiles. Secondary objectives included financial outcomes stratified by payor type across severity quartiles. Methods: Retrospective cohort study included children aged 0-18 years discharged during calendar year 2019 from hospitals that reported clinical information to the Pediatric Health Information System database and …
Patient Attitudes, Perceptions, Knowledge, And Beliefs Regarding Immigration Status In The Healthcare Setting, Anik Patel
Presentations
No abstract provided.
Parental Teach Back In The Ed Setting For Non-English Speaking Families, Rohan Akhouri
Parental Teach Back In The Ed Setting For Non-English Speaking Families, Rohan Akhouri
Presentations
90 million Americans have low health literacy1.in Missouri 35% of adults have prose literacy at or below basic skill level2. Literacy, more specifically health literacy, is a modifiable social determinant of health that has a large impact on patient care and outcome. Poor health literacy in adults is associated with a higher number of ED visits and worse health outcomes3,4. Teach back is a method used in multiple pediatric and adult settings, shown to improve patient outcomes and comfort with discharge instructions5. There is limited data regarding teach back in non-English speaking patients and its efficacy with this group of …
Examining Diagnostic Variability Among Pediatric Subspecialists In Case Examples Of Infant Head Injury, Angela Doswell, Emily Killough, James Anderst, Timothy Zinkus, Ashley Sherman
Examining Diagnostic Variability Among Pediatric Subspecialists In Case Examples Of Infant Head Injury, Angela Doswell, Emily Killough, James Anderst, Timothy Zinkus, Ashley Sherman
Presentations
Background: Clinical presentation, imaging, and ophthalmologic findings are important factors in distinguishing between noninflicted and abusive head trauma (AHT) in infants. However, little is known about agreement between pediatric subspecialists regarding diagnosis and timing of AHT in infants. Hypothesis/Objects: The primary outcome was differences in rates of AHT diagnosis among different types of pediatric subspecialists using case examples of infant head injury. The secondary outcome was qualitative trends in clinical reasoning related to injury timing. Methods: Four case examples of infant head injury were developed into an online survey. Cases were categorized as: (1) “bilateral mixed density subdural hemorrhages (SDHs)”; …
Outpatient Emergency Preparedness, Mary Haywood
Outpatient Emergency Preparedness, Mary Haywood
Presentations
It is commonly believed that medical emergencies do not present to general pediatric offices. However, it has been estimated that 0.9-42 emergencies per office site/year occur. The most common presentations are respiratory in nature. However, children can also present with dehydration, seizure, psychiatric or behavioral complaints. Despite this, most offices are not prepared to handle these presentations for various reasons. Multiple studies have showed that preparedness in inpatient settings is improved with education, implementation, or protocols and deliberate practice with mock codes. However, there have been few studies in the outpatient setting. One study utilized simulation as a tool to …
Spending On Public Benefit Programs And Exposure To Adverse Childhood Experiences, Megan Collins, Matt Hall, P J. Chung, Jessica L. Markham, Jessica L. Bettenhausen, L M. Plencer, Molly Krager, Kathyrn Kyler, D Bard, Kayla R. Heller, Roxana Guggenmous, Jordan Keys, Henry T. Puls
Spending On Public Benefit Programs And Exposure To Adverse Childhood Experiences, Megan Collins, Matt Hall, P J. Chung, Jessica L. Markham, Jessica L. Bettenhausen, L M. Plencer, Molly Krager, Kathyrn Kyler, D Bard, Kayla R. Heller, Roxana Guggenmous, Jordan Keys, Henry T. Puls
Presentations
Background: Adverse childhood experiences (ACEs) have been shown to be associated with poor health outcomes, and children living in poverty are more likely to experience ACEs. Our objective was to estimate the association between spending on benefit programs and cumulative exposure to ACEs among children. Methods: This cross-sectional study examined state and federal spending, at the state-level, on 5 categories of public benefit programs: cash, housing, and in-kind assistance; housing infrastructure; childcare assistance; refundable Earned Income Tax Credit; and Medical Assistance Programs (e.g., Medicaid). The primary exposure was median annual spending per person living below the federal poverty limit across …
Assessing And Addressing Barriers To Fertility Preservation In Pediatric And Adolescent Patients At Risk For Infertility, Emily Burnett, Tennille Hilyard, Julie Strickland
Assessing And Addressing Barriers To Fertility Preservation In Pediatric And Adolescent Patients At Risk For Infertility, Emily Burnett, Tennille Hilyard, Julie Strickland
Presentations
Fertility consultation is a recognized standard that should be offered to pediatric patients with fertility threatening diagnoses or undergoing fertility threatening therapy. The primary objective of this study is to determine how patients who did proceed with fertility preservation differ from those who declined the procedure. This study aims to assess barriers that may contribute to the underutilization of fertility preservation procedures after a formal consultation is completed.