{"title":"Analyzing the CBC for common pediatric hematologic disorders in primary care.","authors":"Charlotte McCrary, Eric J Lowe","doi":"10.1016/j.cppeds.2025.101761","DOIUrl":"10.1016/j.cppeds.2025.101761","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101761"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth K Webb, Amanda A Cavness, William C Owen
{"title":"Evidence-based practice recommendations for infection prevention in pediatric sickle cell patients: Interventions for the primary care provider.","authors":"Elizabeth K Webb, Amanda A Cavness, William C Owen","doi":"10.1016/j.cppeds.2025.101763","DOIUrl":"10.1016/j.cppeds.2025.101763","url":null,"abstract":"<p><p>In this article, we provide pediatric primary care providers (PCPs) with evidence-based recommendations to reduce the risk of life-threatening bacterial infections in pediatric patients with sickle cell disease (SCD). Standard practice guidelines for SCD comprehensive care are lacking in comparison to other chronic diseases. There is a need for continued advocacy for quality healthcare for patients with SCD, including updated standard-of-care guidelines. As a result of these concerning inequities, PCPs and specialty providers are forced to reference and compare recommendations across several different health organizations to identify the best practice. PCPs should feel empowered to follow augmented immunization schedules in pediatric patients with SCD. Immunizations and proper antibiotics can be lifesaving against invasive meningococcal and pneumococcal infections. We outline opportunities for improving quality of care in pediatric patients with SCD for PCPs in the community.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101763"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hemostasis in primary care: A primer.","authors":"Kevin E Todd","doi":"10.1016/j.cppeds.2025.101762","DOIUrl":"10.1016/j.cppeds.2025.101762","url":null,"abstract":"<p><p>Bleeding symptoms in children create significant concern for families and pediatricians alike. This article aims to assist primary care providers in the evaluation of children with bleeding symptoms by reviewing the complexities inherent in diagnosing pediatric bleeding disorders, emphasizing the variability in clinical presentations, testing nuances, and aspects of common bleeding diatheses. The incidence of bleeding disorders among pediatric patients referred for bleeding symptoms and abnormal hemostatic screening remains variable, ranging from 4 % to 11 % across different institutions. A meticulous evaluation-including family history, medication review, and assessment of bleeding severity-is an essential first step in identifying potential bleeding disorders. In patients with a high index of suspicion we recommend screening testing including a complete blood count including blood smear for review, activated partial thromboplastin time (aPTT), prothrombin time (PT), von Willebrand factor (VWF) antigen and activity, and fibrinogen level. Common bleeding disorders in pediatrics include factor deficiencies (including von Willebrand disease) and platelet disorders. A collaborative approach between primary care providers and hematologists is paramount to optimizing outcomes for pediatric patients with bleeding symptoms.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101762"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Foreword-advancing quality improvement Part I","authors":"John M. Pascoe MD, MPH (Associate Editor)","doi":"10.1016/j.cppeds.2025.101755","DOIUrl":"10.1016/j.cppeds.2025.101755","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101755"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial Board Page","authors":"","doi":"10.1016/S1538-5442(25)00054-9","DOIUrl":"10.1016/S1538-5442(25)00054-9","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101780"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Artificial Intelligence in Quality Improvement","authors":"Grant Turek , Kelly C. Sandberg","doi":"10.1016/j.cppeds.2025.101756","DOIUrl":"10.1016/j.cppeds.2025.101756","url":null,"abstract":"<div><div>The introduction of Artificial Intelligence (AI) into the field of medicine be met with hesitation. AI s already showing promise in specific aspects of care and research. Under the guiding hand of clinicians and researchers these new tools can elevate the quality of many different aspects of care. AI tools can benefit the patient, clinician, and quality improver. Embracing and cultivating the work of AI emphasizes the human capabilities of the physician leading to improved clinical care and enhance quality improvement.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101756"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brian Weimerskirch MD, FAAP , Carrie Baker DO, MS, FACEP
{"title":"Data Transparency in Healthcare Quality Improvement","authors":"Brian Weimerskirch MD, FAAP , Carrie Baker DO, MS, FACEP","doi":"10.1016/j.cppeds.2025.101758","DOIUrl":"10.1016/j.cppeds.2025.101758","url":null,"abstract":"<div><div><span>In recent years, the American healthcare system has seen a rapid transition to electronic health records (EHR) and a significant accumulation of digital healthcare information.</span><span><span><sup>1</sup></span></span><sup>,</sup><span><span><sup>2</sup></span></span><span> Having accurate data are key for quality improvement efforts. Unfortunately, a lack of standardization and limited access to stored data have created barriers to its use.</span><span><span><sup>3</sup></span></span><span> The principles of data transparency include making the source and validation methods of the data clearly evident as well as ensuring equitable, easy, and timely access to the data. Data transparency can help utilize this digital transformation to support quality improvement efforts and create an effective learning health system.</span></div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101758"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sustaining improvement gains","authors":"Mellissa Mahabee MD , Maddie VanDorpe BSME , Samantha Neumeier MD","doi":"10.1016/j.cppeds.2025.101757","DOIUrl":"10.1016/j.cppeds.2025.101757","url":null,"abstract":"<div><div>A “system” as described by W. Edwards Deming, the father of the quality movement, is a set of interdependent components – structures, people, and processes – working together towards a common purpose.<span><span><sup>1</sup></span></span><span> Within health systems, the primary intent and common purpose is to promote, restore, and maintain health by focusing on safety, effectiveness, and efficiency. For these reasons, many organizations devote substantial time and resources to build their improvement capability, but these hard-earned improvements fade as the focus changes to other priorities and workers revert to the old system of doing things. To counter this, many health systems are incorporating methods that ensure initiatives continue to help patients in the short term but also become embedded in the system to help future patients.</span></div><div>The Institute for Healthcare (IHI) in their 2016 White Paper suggests that the key to sustaining improvements in systems is to “focus on the daily work of frontline managers, supported by a high-performance management system (HPMS) that prescribes standard tasks and responsibilities for these managers at all levels of the organization.”<sup>2</sup><span> Both these factors are interconnected. An HPMS can be categorized into several areas; quality management<span>, quality control, quality improvement, and a culture of high performance. As a practical example, this paper describes how the IHI framework can be employed to achieve sustainability for quality improvements, using an example of improving problem list utilization at discharge for patients.</span></span></div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101757"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Creating effective PDSA cycles","authors":"Chris Bugnitz MD , Kelly C. Sandberg MD, MSc","doi":"10.1016/j.cppeds.2025.101759","DOIUrl":"10.1016/j.cppeds.2025.101759","url":null,"abstract":"<div><div>Quality improvement<span><span> is achievable in healthcare with the help of a set of tools. One such tool is the Plan-Do-Study-Act cycle, or PDSA cycle. When utilized correctly, PDSA cycles have the potential to effect meaningful change. When used incorrectly, they can defer learning and be counterproductive to quality healthcare. Appropriate use of PDSA cycles will be demonstrated using a ubiquitous challenge in </span>ambulatory care, clinic workflow.</span></div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101759"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beth Williams MBA, BSIE , Lisa R Jasin DNP, PhD, NNP-BC
{"title":"Development of a quality improvement roadmap as a tool to guide quality improvement education and methodology","authors":"Beth Williams MBA, BSIE , Lisa R Jasin DNP, PhD, NNP-BC","doi":"10.1016/j.cppeds.2025.101766","DOIUrl":"10.1016/j.cppeds.2025.101766","url":null,"abstract":"<div><div>Quality improvement in medicine is the process of changing behavior in response to experiential learning. The most referenced quality improvement<span> methodologies include the Institute for Healthcare’s Model for Improvement, Six Sigma, and Lean. The Model for Improvement is the model focused on healthcare and frontline staff. Evidence-based practice models all begin with asking a question, which is shared with quality improvement models. Successful evidence-based practice and quality improvement organizational cultures support a questioning attitude. A quality roadmap developed using both quality improvement and evidence-based practice methodology facilitates the learning process and transition to quality improvement in clinical practice. Use of the quality roadmap framework provides an opportunity to cultivate psychological safety and a questioning attitude. Use of standardized tools, like a quality improvement roadmap in quality improvement positively affects children and their families.</span></div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101766"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}