Hospital pediatrics最新文献

{"title":"The Value Failure of Pediatric Mental Health Boarding.","authors":"Ryan Brogan","doi":"10.1542/hpeds.2026-009477","DOIUrl":"10.1542/hpeds.2026-009477","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e812-e814"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537166","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 Pediatric Hospitalist: A Survey of How We Are Doing.","authors":"Kelsey Jackson, H Barrett Fromme, Elizabeth Nguyen, Kristen Wroblewski, Thomas B Mike","doi":"10.1542/hpeds.2026-009648","DOIUrl":"10.1542/hpeds.2026-009648","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e790-e792"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809278","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":"Patterns in Secure Messaging Among Hospitalists at a Large Children's Hospital.","authors":"Emma Milne, John M Morrison, Jamee Walters","doi":"10.1542/hpeds.2026-009410","DOIUrl":"10.1542/hpeds.2026-009410","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e793-e796"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680400","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":"Clinical Utility of Routine Umbilical Cord Blood Screening for ABO Incompatibility: A Single-Center Observational Study.","authors":"Paige Kube, David L Carola, Neera Goyal, Zubair H Aghai","doi":"10.1542/hpeds.2025-009165","DOIUrl":"10.1542/hpeds.2025-009165","url":null,"abstract":"<p><strong>Background: </strong>The American Academy of Pediatrics suggests 2 approaches for neonates born to blood group O mothers: routine cord blood type and Coombs testing or clinical surveillance with selective testing for jaundiced neonates.</p><p><strong>Objective: </strong>To determine whether routine cord blood testing reduces neonatal intensive care unit (NICU) admissions for hyperbilirubinemia because of ABO incompatibility.</p><p><strong>Study design: </strong>This retrospective pre-post study analyzed all births at one urban, university-affiliated hospital in Pennsylvania from 2007 to 2020. The hospital transitioned from routine cord blood evaluation (2007-2012, period A) to selective evaluation (2013-2020, period B). The primary outcome was transfer from the well baby nursery (WBN) to the NICU for severe hyperbilirubinemia because of ABO incompatibility. Secondary outcomes included peak bilirubin at or above exchange threshold and intravenous immunoglobulin (IVIG) treatment. Chi-square or Fisher exact tests were used to compare differences in outcomes as a percentage of all births across the 2 time periods.</p><p><strong>Results: </strong>Of 29 207 births (12 291 in period A; 16 916 in period B), a total of 1581 neonates were transferred to the NICU from WBN (5.2% in period A vs 5.5% in period B; P = .19). Transfer for hyperbilirubinemia because of ABO incompatibility was more frequent in period B than A (0.11% vs 0.03%; P = .01). During period B, more infants had bilirubin at or above exchange transfusion level (0.06% vs 0.01%; P = .02) and received IVIG (0.06% vs 0%; P = .002).</p><p><strong>Conclusion: </strong>For infants born to blood group O mothers, routine cord blood evaluation vs selective evaluation may prevent severe hyperbilirubinemia requiring NICU transfer.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e777-e780"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608374","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":"Variation in Neonatal Intensive Care and Post-Discharge Outcomes in Military-Insured Newborns.","authors":"David C Goodman, Celeste J Romano, Clinton Hall, JoAnna K Leyenaar, Gia R Gumbs, Thornton S Mu, Ava Marie S Conlin","doi":"10.1542/hpeds.2025-009012","DOIUrl":"10.1542/hpeds.2025-009012","url":null,"abstract":"<p><strong>Objective: </strong>Neonatal care, including intensive care, varies across health care regions. This study measured regional risk-adjusted use of military-insured newborn care and associations with 7-day post-discharge hospital care.</p><p><strong>Patients and methods: </strong>A total of 420 175 live births to military-insured TRICARE beneficiaries, from October 1, 2015 through December 31, 2020, were assigned to regional catchment areas (n = 103) based on birth location. Administrative records provided sponsor/parental/newborn factors associated with neonatal mortality that were used to adjust regional neonatal intensive care unit (NICU) use rates. The associations of these rates and 7-day post-discharge hospital care were estimated with weighted Pearson and Spearman coefficients.</p><p><strong>Results: </strong>Adjusted regional NICU admission rates and numbers of special care days (SCDs) generally varied little for very preterm (VPT) and moderate preterm (MPT) newborns (coefficients of variation [CVs; SD/mean]<10). Regional variation was high for all types of use in late preterm (LPT) and nonpreterm (NPT) newborns (CVs generally >20). Associations between regional NICU admission and 7-day discharge events were weakly negative for LPT (weighted Pearson correlation coefficient, -0.42; 95% CI, -0.56 to -0.25; R2 0.17) and NPT (-0.35; 95% CI, -0.49 to -0.20; R2 0.12) newborns. Correlation coefficients between NICU admission rates and 7-day post-discharge events for VPT and MPT newborns and for the number of SCDs across all subcohorts were not statistically significant. Similar correlations were observed for 30- and 90-day post-discharge outcomes.</p><p><strong>Conclusions: </strong>Regional variation in NICU use was high for LPT and NPT newborns in both military and civilian hospitals and had weak or unassociated risk of post-hospital care.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"850-860"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580351","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 Room Remembers.","authors":"Alexander M Bhatt","doi":"10.1542/hpeds.2026-009454","DOIUrl":"10.1542/hpeds.2026-009454","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e806-e808"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563166","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":"Doing Constructivist Grounded Theory Well: A Practical Guide for Hospitalists.","authors":"Rachel Cane, Jill Owczarzak, Jimmy Beck","doi":"10.1542/hpeds.2026-009441","DOIUrl":"10.1542/hpeds.2026-009441","url":null,"abstract":"<p><p>Grounded theory offers rich possibilities for health-related qualitative research, yet it is frequently misunderstood. Grounded theory is not simply a coding method, but a rigorous methodological approach, with core elements impacting the entire research process, whose goal is to generate a theory that is grounded in the data. Although there is not a unified definition of grounded theory among all its proponents, constructivist grounded theory (CGT) as formulated by Kathy Charmaz is particularly well suited to investigating complex social processes in health care. In this Method/ology article we (1) explain constructivism as a foundational worldview that presumes meaning is coconstructed by individuals through their interactions, (2) outline how the CGT approach grounds both the researcher and their outcomes in the data through an iterative process of data collection and analysis, and (3) describe how the CGT researcher moves beyond descriptive themes to develop a theory or explanatory model of specific social processes. This article highlights common pitfalls in qualitative health care research and provides practical guidance for clinician-researchers interested in pursuing CGT studies.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e819-e823"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707733","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":"Ratio of Postdischarge Emergency Department Visits to Readmissions by Diagnosis.","authors":"Jimin Lee, Melissa J Fazzari, Arti D Desai, Erika L Abramson, Madeline Sterling, Michael L Rinke","doi":"10.1542/hpeds.2025-009083","DOIUrl":"10.1542/hpeds.2025-009083","url":null,"abstract":"<p><strong>Background: </strong>Pediatric readmissions and postdischarge emergency department (ED) visits are common measures of postdischarge use and vary across pediatric conditions. Although often studied separately, these outcomes represent a continuum of hospital reuse. We introduce the ED/READ ratio (the ratio of postdischarge ED visits to readmissions) to characterize diagnosis-specific patterns of hospital reuse across common pediatric conditions.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, we included children aged 0 to 17 years discharged from an urban tertiary children's hospital between July 2016 and December 2019. We included primary All-Patient Refined Diagnosis-Related Groups comprising 1% or more of admissions. The primary outcome was the 30-day ED/READ ratio, calculated as the number of all-cause postdischarge ED visits divided by the number of all-cause readmissions within 30 days of discharge, computed for each diagnosis with 95% CIs.</p><p><strong>Results: </strong>Among 16 518 hospitalizations from 11 728 patients, the overall 30-day postdischarge ED visit rate was 8.1% and the readmission rate was 9.2%. The 30-day ED/READ ratio ranged from 0.08 (95% CI, 0.05-0.12) for chemotherapy to 2.41 (95% CI, 1.50-3.33) for tonsil and adenoid procedures. Diagnoses with ratios significantly more than 1 included asthma, bronchiolitis and respiratory syncytial virus pneumonia, and gastroenteritis; ratios less than 1 included chemotherapy, sickle cell anemia crisis, and seizures.</p><p><strong>Conclusion: </strong>The ED/READ ratio is a descriptive metric that complements traditional measures by characterizing diagnosis-specific patterns of postdischarge reuse across care settings. Used alongside existing metrics, the ratio may help generate hypotheses about diagnosis-specific targets for improvement. Further research is needed to evaluate its reproducibility and applications across diverse settings.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"889-895"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537203","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":"Caregiver Perspectives on Implementation of Discharge Plans for Children With Medical Complexity.","authors":"Alexander F Glick, Susan Landon, Fabiola Morales Tirado, H Shonna Yin, Lea Vaydie Silveiro, Jonathan S Farkas, Emily J Goodwin, Avani C Modi, Karol Piotrowski, Emily Clementi, Victoria V Dickson","doi":"10.1542/hpeds.2025-009031","DOIUrl":"10.1542/hpeds.2025-009031","url":null,"abstract":"<p><strong>Objective: </strong>The quality of discharge processes impacts adverse outcomes post hospitalization for children with medical complexity (CMC). Perspectives of caregivers at risk for communication challenges (eg, non-English speakers, those with limited health literacy, immigrants) on understandability and feasibility of discharge instructions for CMC are understudied. Our objective was to explore their perspectives on barriers and facilitators to comprehension and implementation of discharge instructions for CMC.</p><p><strong>Patients and methods: </strong>In this qualitative, descriptive study, we used maximum variation sampling to enroll caregivers of CMC (N = 40) discharged from acute or intensive care units of 2 urban hospitals. English- and Spanish-speaking caregivers of CMC (Pediatric Medical Complexity Algorithm) aged 18 years or older and discharged on 1 or more daily medications were eligible. We conducted semistructured interviews, audio-recorded and transcribed interviews, and performed content analysis. Two team members applied codes from a codebook (developed based on prior literature and preliminary analyses) and identified emerging themes.</p><p><strong>Results: </strong>Equal numbers of participants spoke English and Spanish (n = 20 per language) and were recruited from each hospital (n = 20 per hospital). Half (47.5%) had low health literacy; 85% were of non-US birth. Themes emerged across 4 categories: (1) clinician and medication access; (2) patient- and family-centered approaches to discharge planning and education; (3) caregiver prior experience; and (4) resources and support systems.</p><p><strong>Conclusions: </strong>Caregivers identified barriers and facilitators affecting discharge plan comprehension and implementation. Optimizing postdischarge care for CMC is complex and requires family-centered, language-concordant, and health literacy-informed processes. Future interventions should focus on systems-level changes that enhance access and account for caregiver perspectives.</p>","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"861-871"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702081","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":"The Essential Role of Pediatric Trainees in Developing Ethical Artificial Intelligence Tools.","authors":"Regan Hill, Haniyah Syed, Nicholas Porter, Logan Pearson","doi":"10.1542/hpeds.2026-009471","DOIUrl":"10.1542/hpeds.2026-009471","url":null,"abstract":"","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e809-e811"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550730","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}