Hospital pediatrics最新文献

{"title":"Defining the Hospitalist Workforce in the Care of Newborns.","authors":"Neha S Joshi, Arun Gupta, Rakhi Gupta Basuray, Krista Birnie, Allison Markowsky, Shimona Thakrar, Sandra Motta, Juliann L Kim","doi":"10.1542/hpeds.2024-008295","DOIUrl":"10.1542/hpeds.2024-008295","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric hospital medicine is a rapidly growing new subspecialty. Although many practice newborn care, this subset of hospitalists has not been described. The objective of this study was to define the hospitalist workforce in the care of newborns during the birth hospitalization, including describing job characteristics of newborn hospitalists and nursery sites for clinical practice.</p><p><strong>Methods: </strong>An 81-question web-based survey was distributed to a convenience sample of 418 hospitalists taking care of newborns during the birth hospitalization in September and October 2024. We performed descriptive statistics and tests of association.</p><p><strong>Results: </strong>We had 336 respondents, for a response rate of 80%. Among 336 respondents, 451 nursery sites were described. Hospitalists at nearly all sites independently managed infants in level I nurseries (n = 436, 97%), with 38% (n = 170) managing infants in level II special care nurseries. Hospitalists attended deliveries at 45% (n = 203) of sites and were more likely to attend at community sites (P < .001), in rural settings (P < .001), and at sites with lower annual delivery volumes (P < .001). Hospitalists at most sites spent most of their daily clinical time on the care of newborns (n = 378, 84%) with 47% (n = 210) spending more than 90% of daily clinical time on newborn care.</p><p><strong>Conclusions: </strong>Among surveyed hospitalists who provide care for newborns during the birth hospitalization, newborn care presented most of their clinical workload. Nearly all independently managed infants in level I nurseries, with a subset managing infants in level II special care nurseries. This survey is the first characterization of hospitalists and their care of newborns and serves as a primer for further understanding of this workforce.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"630-636"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Shifts in the Pediatric Hospital Medicine Job Market.","authors":"Katherine Salada, Matthew Hazle, Harlan McCaffery, Niko Kaciroti, H Barrett Fromme","doi":"10.1542/hpeds.2024-008277","DOIUrl":"10.1542/hpeds.2024-008277","url":null,"abstract":"<p><strong>Objective: </strong>To describe potential differences in pediatric hospital medicine (PHM) hiring practices based on board certification/board eligibility (BC/BE) status.</p><p><strong>Methods: </strong>Following the literature review, an electronic survey was developed by investigators, with feedback from division leaders representing 4 divisions and 3 institutions. The survey was administered nationally to PHM leaders via PHM listservs in the spring of 2023 and inquired about institution demographics, division characteristics, and hiring practices for the 2022 to 2023 recruitment season. Subanalysis was completed by BE status: (1) fellowship trained, (2) practice pathway eligible, and (3) non-BC/BE.</p><p><strong>Results: </strong>A total of 76 division leaders responded, representing community (41%), university (37%), and combined (22%) sites. Division directors interviewed a median of 5 (IQR, 3-8) physicians to fill a median of 1.9 (IQR, 1-3) available full-time equivalent. There was no difference in interviews extended, jobs offered, or candidates hired based on BE status. BC/BE candidates had lower odds of being hired at community sites (odds ratio [OR], 0.26; P = .01) and higher odds of receiving academic rank (OR, 2.05; P = .01) compared with non-BC/BE candidates. There was no difference in salary, time on teaching services, or time on faculty-only services based on BE status.</p><p><strong>Conclusion: </strong>Non-BC/BE candidates continue to have a diverse array of job opportunities in PHM. However, some variability in PHM job characteristics has emerged among candidates from different BC/BE pathways. Further study is required to understand how shifting trends in hiring impact learner training, faculty compensation, and academic productivity of PHM divisions.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"637-644"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequities in Length of Stay for Pediatric Patient Families Using Languages Other Than English for Care.","authors":"Paula E Lopez-Perez, Elyse N Portillo, Michael Silver, Alexandra Coria","doi":"10.1542/hpeds.2024-008050","DOIUrl":"10.1542/hpeds.2024-008050","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the correlation between use of language other than English (LOE) for care and length of stay (LOS) in children admitted to the hospital.</p><p><strong>Methods: </strong>Single-center retrospective cohort study at an urban children's hospital including medical and surgical patients aged 0 to 17 years admitted to our pediatric inpatient floor or pediatric intensive care unit between January 1, 2018 and January 1, 2020. LOE families were defined as those with documented use of language interpretation and/or who identified as using LOE for care during registration. LOS in hours and numbers of nights was compared across LOE and English-speaking groups with a Mann-Whitney U test, and across language groups using a Kruskal-Wallis Test. LOS analyses of the surgical population were done using Mann-Whitney U test. A multivariable linear regression model was fit to predict the relationship between LOE and LOS in hours and a negative binomial model was fit to predict number of nights in the hospital, controlling for social work consults, medical consults and acuity at presentation.</p><p><strong>Results: </strong>4755 patients were included. Median LOS in the LOE group was 64 hours, 6 hours longer than the English group (P < .001). The LOE group stayed in the hospital a median of one night longer (P < .001) than the English group. Families who spoke a Chinese dialect had the longest LOS (median 70 hours) among language subgroups. LOS was longer for LOE patients in both medical (66 hours vs 60 hours, P < .001) and surgical (48 hours vs 42 hours, P < .001) subgroups. LOS was longer for patients with LOE when controlling for social and medical complexity and acuity at presentation.</p><p><strong>Conclusions: </strong>Use of LOE for care was associated with longer LOS, including a higher median number of hospital overnights. Findings were particularly pronounced in Chinese-speaking families and extended to surgical patients. An extra hospital night is a clinically significant difference that could increase the risk of hospital-acquired infections, raise costs, and decrease patient satisfaction.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"645-651"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Approaches for Navigating Authorship Conflict.","authors":"Paul Michel, Priti Bhansali, Lisa E Herrmann, Neha Shah, Steven Marek","doi":"10.1542/hpeds.2025-008326","DOIUrl":"10.1542/hpeds.2025-008326","url":null,"abstract":"<p><p>Authorship confers both credit and responsibility for original scientific research. It is a highly prized, currency-like resource in academic medicine, and discussing it transparently with colleagues can feel as uncomfortable as talking about salaries. Junior researchers especially need to feel confident in their approach to navigating contentious authorship scenarios because they arise so commonly in academic research. Fortunately, there are simple tools researchers can employ to successfully prevent and navigate most authorship conflict. With these tools, researchers can systematically identify authors, outline author roles, recognize common forms of authorship conflict, and escalate conflict to appropriate channels for resolution.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e416-e419"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Components of Family Meetings for Hospitalized Children With Serious Illness: A Scoping Review.","authors":"Aisling Semple, Melissa Finlay, Asiya Ali, Kate Tsiandoulas, Vishu Chakravarti, Francine Buchanan, Kimberley Widger, Catherine Diskin, Katherine E Nelson","doi":"10.1542/hpeds.2024-008302","DOIUrl":"10.1542/hpeds.2024-008302","url":null,"abstract":"<p><strong>Context: </strong>Family meetings between pediatric clinicians and parents are used to facilitate in-depth discussions and decision-making about patient care. To guide implementation of family meetings for hospitalized children with medical complexity, this scoping review identified the common components of family meetings for hospitalized pediatric patients with serious illness across pediatric subspecialties.</p><p><strong>Objective: </strong>To describe key components of family meetings for hospitalized pediatric patients with serious illness.</p><p><strong>Data sources: </strong>With the assistance of a professional librarian, we searched 5 databases.</p><p><strong>Study selection: </strong>We included primary research studies describing planned interactions between 2 or more health care providers and family decision-makers for hospitalized children with serious illness.</p><p><strong>Data extraction: </strong>We extracted components of family meetings, which we organized based on timing (before, during, and after the meeting) and combined thematically.</p><p><strong>Results: </strong>We evaluated 11 151 title/abstracts, reviewed 77 full-text articles, and included 23 articles describing 21 studies. Most studies focused on meetings in intensive care units (96%), were conducted in the United States (91%), and were published after 2020 (52%). We identified 15 components occurring before (n = 4), during (n = 8), and after (n = 3) family meetings. Components included both specific tasks (identify need for a meeting) and communication goals (assess and support understanding). Most components were identified through study observations rather than recommendations made by the researchers.</p><p><strong>Conclusion: </strong>There is a developing body of evidence about family meetings, which is largely focused on intensive care settings, that can inform development of targeted research to support implementation of family meetings in pediatric hospital medicine.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e392-e403"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Moderating Effects of Waiver Enrollment and Home Nursing Care on Hospitalization Risk.","authors":"Caitlin Koob, Elizabeth Mack, Sarah Griffin","doi":"10.1542/hpeds.2024-008215","DOIUrl":"10.1542/hpeds.2024-008215","url":null,"abstract":"<p><strong>Objectives: </strong>This study identifies factors associated with hospitalization and examines the moderating effects of South Carolina Medicaid's Medically Complex Children's Waiver (MCCW) enrollment and receipt of home nursing care (HNC) on hospitalization risk among Medicaid-insured children with medical complexity in South Carolina from 2019 to 2022.</p><p><strong>Methods: </strong>We analyzed retrospective Medicaid claims data from 783 149 billed home health care claims among 4484 children aged 0 to 21 years in South Carolina from 2019 to 2022. The outcome of interest was experiencing at least 1 hospitalization from 2019 to 2022. The Pediatric Medical Complexity Algorithm version 3.0 was applied, using International Classification of Diseases, Tenth Revision (ICD-10) codes to classify diagnoses as either a complex chronic disease (C-CD) or a noncomplex chronic disease (NC-CD).</p><p><strong>Results: </strong>Children with a C-CD aged 0 to 4 and 20 to 21 years who identified with a race and ethnicity other than non-Hispanic white, were primarily insured by Medicaid, and received services in 2020 and 2021 had significantly higher hospitalization risk compared with other children. Controlling for MCCW, HNC had a mediating effect on hospitalization risk for CMC with a C-CD (odds ratio [OR] 1.03, 95% CI: 1.02-1.04, compared with children with an NC-CD). Children with a C-CD who received HNC had significantly lower hospitalization risk (adjusted OR [AOR] 0.87, 95% CI: 0.85-0.89) compared with children with an NC-CD. Children who received HNC in 2020 (AOR 0.90, 95% CI: 0.84-0.96) and 2021 (OR 0.92, 95% CI: 0.86-0.98) had significantly lower odds of hospitalization(s) compared with those without nursing in 2019.</p><p><strong>Conclusions: </strong>MCCW enrollment lowers hospitalization risk to an extent; however, HNC may have reduced hospitalization risk throughout the COVID-19 pandemic. Further research is needed to understand the intricacies of South Carolina Medicaid's MCCW and to improve health among Medicaid-insured children in South Carolina.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"667-675"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future-Proofing Pediatric Hospital Medicine: Medical Education in Workforce Sustainability.","authors":"Monisha Sachdev, Averi E Wilson, Kelci B Butler","doi":"10.1542/hpeds.2025-008523","DOIUrl":"10.1542/hpeds.2025-008523","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e386-e388"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If It Were That Simple, We Would Have Done It Already: Perspectives From the Sandwich Generation of Inpatient Physicians.","authors":"Erica Andrist, Naomi Laventhal","doi":"10.1542/hpeds.2025-008622A","DOIUrl":"https://doi.org/10.1542/hpeds.2025-008622A","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":"15 8","pages":"e420"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Window Into Life as a Newborn Hospitalist: What Can the Next Generation Expect?","authors":"Grace Rivera Owen, Paul H Lerou, Leela Sarathy","doi":"10.1542/hpeds.2025-008401","DOIUrl":"10.1542/hpeds.2025-008401","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e389-e391"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Potentially Avoidable Pediatric Intensive Care Unit Transfers.","authors":"Anna Jane Sibilia, Maya Dewan, Abigail Gauthier, Imogene Clover-Brown, Ellen Pittman, Ranjit S Chima","doi":"10.1542/hpeds.2025-008338","DOIUrl":"10.1542/hpeds.2025-008338","url":null,"abstract":"<p><strong>Background and objective: </strong>Rapid response systems (RRSs) assess and transfer patients from general care units to the pediatric intensive care unit (PICU) and are necessary to safely care for hospitalized patients. A proportion of patients who transfer to the PICU do not receive PICU-specific care and may be considered potentially avoidable transfers (PATs). The objective of this study is to describe and characterize PATs at a quaternary free-standing children's hospital.</p><p><strong>Patients and methods: </strong>Reasons for RRS activation were collected using a prospective survey at the time of RRS activation. Retrospective chart review was conducted on PICU transfers to determine if they met criteria for PAT. PATs were identified if the patient did not experience a critical deterioration event, could not be classified as an emergent transfer, or did not undergo any PICU-specific interventions.</p><p><strong>Results: </strong>Nearly half (110/255; 43%) of transfers to the PICU via RRS were classified as PATs. Median time from admission to transfer was 32 hours (interquartile range 13.2-99.4) with a median age of 6 years (interquartile range 1.52-14.74). PATs most commonly came from the general pediatrics unit (33%). The most common reason for transfer for PATs was respiratory distress.</p><p><strong>Conclusions: </strong>PATs made up nearly half of transfers from the general care unit to the PICU. We propose that PATs can be considered a balancing metric in the assessment of RRSs, especially as inpatient pediatric care is becoming increasingly limited.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"660-666"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}