journal
https://read.qxmd.com/read/38993274/improving-pediatric-hypertension-screening-in-an-academic-primary-care-setting
#1
JOURNAL ARTICLE
Vildan Tas, Esma Birisci, Rachel Achor Jones, John J Forbus, Richard T Blaszak, Brendan Crawford, Mohammad Ilyas, James S Magee, Laura L Sisterhen
INTRODUCTION: Adherence to the American Academy of Pediatrics clinical practice guidelines for screening and managing high blood pressure (BP) is low. This team sought to improve recognition and documentation of relevant diagnoses in patients aged 13-20 years who presented to general pediatric clinics. METHODS: The primary outcome measure was the proportion of office visits for patients ages 13-20 with a BP ≥ 120/80 with a visit or problem list diagnosis of hypertension or elevated BP...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38993273/substance-use-screening-in-a-large-pediatric-primary-care-network-a-quality-improvement-project
#2
JOURNAL ARTICLE
Dave Karas, Lisa Eggleston, William Goldman, Mike Bigham, P Cooper White
BACKGROUND: This project aimed to introduce substance use screening, using the CRAFFT (Car, Relax, Alone, Forget, Family/Friends, Trouble) screening tool, into the routine care of adolescents using quality improvement strategies and tools. METHODS: We expanded a single-site project showing the successful introduction of CRAFFT screening into adolescent care to include the entire 34-site primary care network of a children's hospital in Northeastern Ohio. We deployed quality improvement methodology to facilitate the acceptance and use of the screener...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38993272/combating-disparities-in-a-pandemic-increasing-dissemination-of-coronavirus-disease-2019-resources-in-spanish
#3
JOURNAL ARTICLE
Romina L Barral, Nicholas A Clark, Fernando Zapata, Lines M Vargas Collado, July Jean Cuevas, Cristina Fernandez
INTRODUCTION: Disparities exist in access to coronavirus disease 2019 (COVID-19)-related health information. We aimed to close a gap in online traffic between English and Spanish COVID-19-related health information on our institution's publicly-facing website by 50% within ten months. METHODS: We used A3 improvement methodology. Outcome measures were the mean monthly difference between English and Spanish COVID-19 online traffic vis-a-vis (1) total webpage views and (2) unique webpage visits...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38993271/improving-interpreter-access-in-the-pediatric-emergency-department-a-quality-improvement-initiative
#4
JOURNAL ARTICLE
Katherine E Douglas, Miriam T Fox, Christine C Cheston, M Laxmi Behara, Kyle A Schoppel
BACKGROUND: An increasing proportion of the population in the United States have limited English proficiency (LEP). Hospitals that receive federal funding must offer interpreter services. However, access is often lacking for patients. Patients with LEP are at higher risk for adverse events, and the Emergency Department is a particularly high-risk environment for these events. METHODS: This quality improvement initiative took place from April 2021 to August 2022 in an urban, tertiary care Pediatric Emergency Department...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38993270/a-quality-improvement-project-to-improve-after-visit-summary-patient-instructions-in-a-pediatric-multidisciplinary-neuromuscular-program
#5
JOURNAL ARTICLE
Agathe M de Pins, Dorothy Adu-Amankwah, Kristin A Shadman, Skylar M Hess, Cordelia R Elaiho, Liam R Butler, Sheena C Ranade, Brijen J Shah, Robert Fields, Elaine P Lin
INTRODUCTION: Multidisciplinary clinics aim to coordinate care between multiple specialties for children with medical complexity yet may result in information overload for caregivers. The after-visit summary (AVS) patient instruction section offers a solution by summarizing visit details and recommendations. No known studies address patient instruction optimization and integration within a multidisciplinary clinic setting. This project aimed to improve the quality of patient instructions to support better postvisit communication between caregivers and providers in a multidisciplinary pediatric neuromuscular program...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38993269/increasing-screening-rates-for-comorbidities-in-adolescents-with-elevated-body-mass-index-in-pediatric-primary-care
#6
JOURNAL ARTICLE
David R Karas, Sharon Juszli, Marnie Walston, April Love, Michael T Bigham
INTRODUCTION: Adolescents with elevated body mass index are at increased risk for comorbidities such as dyslipidemia, diabetes mellitus, and metabolic dysfunction-associated steatotic liver disease. Guideline-based screening can identify impacted patients early, allowing for lifestyle modifications and other treatments to improve long-term health. Unfortunately, only 20% of pediatric patients with obesity receive recommended screening. METHODS: A multidisciplinary quality improvement team designed and implemented a project to improve comorbidity screening utilizing the Model for Improvement...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38868761/quality-improvement-in-neonatal-care-successful-adoption-of-the-eat-sleep-console-protocol-in-a-rural-hospital-setting
#7
JOURNAL ARTICLE
Riley Phyu, Charrell Bird, Ashish Gupta
INTRODUCTION: The United States faces a growing burden of neonatal opioid withdrawal syndrome in rural hospitals. Traditional treatments often extend hospital stays and medication use. The Eat, Sleep, and Console (ESC) approach offers a new management strategy but is challenging in resource-limited settings. This study aimed to apply ESC in rural hospitals to reduce neonatal intensive care unit admissions, decrease length of stay (LOS) to under 7 days, and lower medication use by more than 80% within a year...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38868760/developing-a-sustainable-quality-improvement-program-in-an-academic-center-the-experience-of-an-adolescent-unit
#8
JOURNAL ARTICLE
Erin R McKnight, Ashley Ebersole, James Gallup, Fareeda W Haamid
INTRODUCTION: Successful quality improvement (QI) efforts use a comprehensive, institutional QI framework and professional development, but literature describing implementing QI frameworks in Adolescent Medicine practices is sparse. We aimed to implement and increase the number of formally structured QI projects (primary aim) and the number of projects achieving a centerline (CL) shift (secondary aim) in our hospital's Adolescent Medicine Clinic. METHODS: We used formal QI methodology to improve health outcomes by increasing the number of faculty with formalized QI education, creating interdisciplinary QI teams, and improving staff motivation...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38868759/measuring-the-interprofessional-health-of-the-pediatric-cardiovascular-operating-room-work-environment
#9
JOURNAL ARTICLE
Jason M Thornton, Jean A Connor, Patricia A Dwyer, Courtney L Porter, Lauren P Hartwell, Zachary DiPasquale, Araz Chiloyan, Patricia A Hickey
INTRODUCTION: Pediatric cardiac surgery is complex and has significant risk, requiring interprofessional teamwork for optimal outcomes. Unhealthy work environments have been linked to poor patient outcomes, staff dissatisfaction, and intention to leave. We describe the interprofessional health of pediatric cardiovascular operating room (CVOR) work environments in the United States and the establishment of a healthy work environment (HWE) benchmark score. METHODS: Utilizing the American Association of Critical Care Nurses Healthy Work Environments Assessment Tool (HWEAT), interprofessional staff from 11 pediatric CVORs were surveyed...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38868758/a-quality-initiative-to-prioritize-enteral-feeding-in-bronchiolitis
#10
JOURNAL ARTICLE
Nicholas Beam, Allison Long, Adam Nicholson, Lauren Jary, Rebecca Veele, Nicole Kalinowski, Matthew Phad, Andrea Hadley
INTRODUCTION: Recent studies have identified enteral feeding as a safe alternative to intravenous fluid hydration for inpatients with bronchiolitis receiving respiratory support. Specifically, it can improve vital signs, shorten time on high-flow nasal cannula, and is associated with reduced length of stay. We aimed to increase the percentage of patients receiving enteral feeding on admission with mild-to-moderate bronchiolitis, including those on high-flow nasal cannula, from 83% to 95% within 6 months...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38868757/a-quality-initiative-to-improve-appropriate-medication-dosing-in-pediatric-patients-with-obesity
#11
JOURNAL ARTICLE
Colleen P Cloyd, Danielle Macedone, Jenna Merandi, Shawn Pierson, Maria Sellas Wcislo, Jeffrey Lutmer, Jennifer MacDonald, Onsy Ayad, Lindsay Kalata, R Zachary Thompson
INTRODUCTION: Emerging evidence supports the use of alternative dosing weights for medications in patients with obesity. Pediatric obesity presents a particular challenge because most medications are dosed based on patient weight. Additionally, building system-wide pediatric obesity safeguards is difficult due to pediatric obesity definitions of body mass index-percentile-for-age via the Center for Disease Control growth charts. We describe a quality initiative to increase appropriate medication dosing in inpatients with obesity...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38868756/reducing-time-from-pediatric-emergency-department-arrival-to-dexamethasone-administration-in-wheezing-patients
#12
JOURNAL ARTICLE
Andrew W Kramer, Jessica Erlich, Karen Yaphockun, Daniel Roderick, Kristen Farkas, Amy W Bryl, Kathryn H Pade
INTRODUCTION: Asthma exacerbations are common presentations to pediatric emergency departments. Standard treatment for moderate-to-severe exacerbations includes administration of oral corticosteroids concurrently with bronchodilators. Early administration of corticosteroids has been shown to decrease emergency department length of stay (LOS) and hospitalizations. Our SMART aim was to reduce the time from arrival to oral corticosteroids (dexamethasone) administration in pediatric patients ≥2 years of age with an initial Pediatric Asthma Severity Score >6 from 60 to 30 minutes within 6 months...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38854502/quality-improvement-initiative-enhances-outpatient-pediatric-pulmonology-follow-up-for-premature-infants-with-bronchopulmonary-dysplasia
#13
JOURNAL ARTICLE
Eliaz Brumer, Sanjiv Godse, Leela Chandrasekar, Tuba Kockar Kizilirmak, Eleanor Blythe, Yeisid Gozzo, Steven Peterec, Sarah Kandil, Matthew Grossman, Laura Chen, Pnina Weiss, Beverley Sheares
INTRODUCTION: Bronchopulmonary dysplasia (BPD) is a chronic lung disorder affecting many premature infants. Infants with BPD have higher hospital readmission rates due to respiratory-related morbidity. We aimed to increase the rates of outpatient pulmonary follow-up and attendance of premature babies with moderate and severe BPD to above 85% within 6 months. METHODS: We conducted a quality improvement project at Yale New Haven Children's Hospital. Key interventions included developing a BPD clinical pathway integrated into the electronic medical record to assist providers in correctly classifying BPD severity, assigning the appropriate International Classification of Diseases, 10th Revision code (P27...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38807584/improving-turnaround-time-of-transabdominal-pelvic-ultrasounds-with-ovarian-doppler-in-a-pediatric-emergency-department
#14
JOURNAL ARTICLE
Amanda S Dupont, Patrick C Drayna, Mark Nimmer, Shannon H Baumer-Mouradian, Kendra Wirkus, Danny G Thomas, Kevin Boyd, Sri S Chinta
INTRODUCTION: Adnexal torsion is an emergent surgical condition. Transabdominal pelvic ultrasound (US) with ovarian Doppler is used to diagnose adnexal torsion and requires a sufficient bladder volume. Reduce the turnaround time for US by 25% in girls 8-18 years of age who present to the emergency department (ED) for 24 months. METHODS: Our baseline period was from January 2020 to June 2021, and the intervention period was from July 2021 to June 2023. Patients 8-18 years old who required an US in the ED were included...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38807583/beyond-ltrasound-readiness-a-needs-assessment-for-improving-care-in-children-with-ovarian-torsion
#15
JOURNAL ARTICLE
Shawn J Rangel
No abstract text is available yet for this article.
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38807582/screening-for-nephropathy-in-pediatric-type-2-diabetes-quality-improvement-to-increase-nephropathy-screening
#16
JOURNAL ARTICLE
Elizabeth A Mann, Kelsi Alexander, Whitney Beaton, Elizabeth B Roe, Amy Grant, Kristin A Shadman
BACKGROUND: Screening for early detection of microalbuminuria signaling kidney disease should begin as early as the time of diagnosis of youth-onset type 2 diabetes. This quality improvement initiative aimed to standardize urine nephropathy screening in pediatric patients with type 2 diabetes at a tertiary academic medical center and increase a baseline screening rate of 56%-75% over 6 months (September 2022-February 2023) and sustain that increase for 6 months (March through August 2023)...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38807581/quality-improvement-identifies-healthcare-transition-disparities-in-adolescents-with-congenital-heart-disease-and-disabilities
#17
JOURNAL ARTICLE
Catherine C Allen, Briana L Swanson, Xiao Zhang, Ryan J Coller, Krisjon R Olson
INTRODUCTION: We aim to implement healthcare transition (HCT) education for youth with congenital heart disease (CHD) and assess HCT preparedness for cardiac self-care. METHODS: An HCT clinic was implemented at an academic pediatric cardiology clinic for CHD youth 17 years of age and older. An educator used transition readiness assessment questionnaires and discussed HCT material. The percentage of eligible youth who received HCT education and the cause for missed occurrences were tracked...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38751898/postcardiac-arrest-care-delivery-in-pediatric-intensive-care-units-a-plan-and-call-to-action
#18
JOURNAL ARTICLE
Jessica A Barreto, Jesse Wenger, Maya Dewan, Alexis Topjian, Joan Roberts
BACKGROUND: Despite national pediatric postcardiac arrest care (PCAC) guidelines to improve neurological outcomes and survival, there are limited studies describing PCAC delivery in pediatric institutions. This study aimed to describe PCAC delivery in centers belonging to a resuscitation quality collaborative. METHODS: An institutional review board-approved REDCap survey was distributed electronically to the lead resuscitation investigator at each institution in the international Pediatric Resuscitation Quality Improvement Collaborative...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38751897/emergency-department-initiative-to-decrease-high-flow-nasal-cannula-use-for-admitted-patients-with-bronchiolitis
#19
JOURNAL ARTICLE
Courtney E Nelson, Jonathan M Miller, Chalanda Jones, Emily Reese Fingado, Ann-Marie Baker, Julie Fausnaugh, Michael Treut, Leah Graham, Katlyn L Burr, Arezoo Zomorrodi
BACKGROUND: Despite limited evidence, a high-flow nasal cannula (HFNC) is often used to treat mild to moderate (m/m) bronchiolitis. We aimed to decrease the rate of HFNC use in the pediatric emergency department (PED) for m/m bronchiolitis from a baseline of 37% to less than 18.5%. METHODS: A multidisciplinary team created a bronchiolitis pathway and implemented it in December 2019. A respiratory score (RS) in the electronic medical record objectively classified bronchiolitis severity as mild, moderate, or severe...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38751896/transforming-into-a-learning-health-system-a-quality-improvement-initiative
#20
JOURNAL ARTICLE
Jennifer L Chiem, Elizabeth E Hansen, Nicolas Fernandez, Paul A Merguerian, Sanjay R Parikh, Kayla Reece, Daniel K Low, Lynn D Martin
BACKGROUND: The Institute of Medicine introduced the Learning Healthcare System concept in 2006. The system emphasizes quality, safety, and value to improve patient outcomes. The Bellevue Clinic and Surgical Center is an ambulatory surgical center that embraces continuous quality improvement to provide exceptional patient-centered care to the pediatric surgical population. METHODS: We used statistical process control charts to study the hospital's electronic health record data...
2024: Pediatric Quality & Safety
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