Current Problems in Pediatric and Adolescent Health Care最新文献

{"title":"FOREWORD- COVID-19 and Children's behavioral health","authors":"John M. Pascoe MD, MPH (Associate Editor)","doi":"10.1016/j.cppeds.2023.101492","DOIUrl":"10.1016/j.cppeds.2023.101492","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471119","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(23)00168-2","DOIUrl":"https://doi.org/10.1016/S1538-5442(23)00168-2","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1538544223001682/pdfft?md5=4e66d871259c7b7b6291572722ed7a47&pid=1-s2.0-S1538544223001682-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138557552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing physical restraints in pediatrics: A quality improvement mixed-methods analysis of implementing a clinical debriefing process after behavioural health emergencies in a Children's Hospital","authors":"Paul C. Mullan MD, MPH ,&nbsp;Andrea D. Jennings RN, BCN ,&nbsp;Erin Stricklan RN ,&nbsp;Elizabeth Martinez RN ,&nbsp;Monica Weeks RN ,&nbsp;Karen Mitchell RN ,&nbsp;Turaj Vazifedan DHSc ,&nbsp;Rachel Andam-Mejia MSN, RN ,&nbsp;Daniel B. Spencer MD","doi":"10.1016/j.cppeds.2023.101463","DOIUrl":"10.1016/j.cppeds.2023.101463","url":null,"abstract":"<div><h3>Introduction</h3><p>An increasing number of pediatric patients with mental and behavioral health (MBH) conditions present to Emergency Department<span> (ED) and inpatient settings with behavioral events that require physical restraint (PR). PR usage is associated with adverse outcomes. Clinical debriefing (CD) programs have been associated with improved performance but have not been studied in this population. After implementing an MBH-CD program in our Children's Hospital, we aimed to decrease the baseline (7/2018-3/2021) rate of a second PR episode (2PR) by 50 % in the ED and inpatient settings over two years.</span></p></div><div><h3>Methods</h3><p>A multidisciplinary team implemented an MBH-CD process in April 2021 for hospital teams to use immediately after behavioral events. We included patients ≤18 years old, with an ED or inpatient discharge MBH diagnosis, between July 2018 and June 2023. Pre- and post-implementation secondary outcomes included the ED median duration of PR and the ED PR time per 1000 h of ED care. ED and inpatient mean length of stay (LOS) and mean monthly visits (MMV) in pre- and post-implementation were also compared. Qualitative analysis identified major themes.</p></div><div><h3>Results</h3><p>Post-implementation, the ED significantly decreased 2PR rate by 67 %; in inpatients, no significant change was demonstrated. Median duration of ED PR decreased from 112 to 71 min (<em>p</em> = 0.006) and ED PR time significantly decreased by 82 % (14.8 to 2.7 h per 1000 h). In the post-implementation period, mean LOS (ED and inpatient) and MMV (ED only) were significantly higher. Fifty-one percent of 494 behavioral alerts were debriefed. Median debriefing duration was 6 min (IQR 4,10). Common themes included cooperation and coordination (23 %) and clinical standards (14 %).</p></div><div><h3>Discussion</h3><p>Clinical debriefing implementation was associated with significant improvement in ED patient outcomes. Inpatient outcomes were unchanged, but debriefings in both settings should enable frontline teams to continuously identify opportunities to improve future outcomes.</p></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435275","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":"Pediatric preoperative bathing process: An infection prevention perspective for development of a highly reliable organization","authors":"Merissa Doyle MPH,&nbsp;Darian Dean BSPH,&nbsp;Vetra Peyton MPH,&nbsp;Barbara Stein BSN, RN, CIC","doi":"10.1016/j.cppeds.2023.101465","DOIUrl":"10.1016/j.cppeds.2023.101465","url":null,"abstract":"<div><p>Surgical site infections are a burden to patients, families and healthcare systems. Preoperative preparation is a crucial part in the multifaceted approach to SSI prevention. Preoperative bathing is a customary procedure that is seemingly straightforward yet challenging to implement. On the basis of best-practices and lived experience, this essay identifies potential barriers and presents several recommendations for improvement of preoperative preventive measures.</p></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292199","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(23)00159-1","DOIUrl":"https://doi.org/10.1016/S1538-5442(23)00159-1","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1538544223001591/pdfft?md5=65d023b8636202bc5e40299d59eec247&pid=1-s2.0-S1538544223001591-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138501409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue 2 Integrating and Implementing Quality Improvement into our Pediatric Healthcare System","authors":"John W. Harrington MD","doi":"10.1016/j.cppeds.2023.101462","DOIUrl":"10.1016/j.cppeds.2023.101462","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177602","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":"Integrating quality improvement into healthcare operations: A system's approach","authors":"Amanda Pellerito MA, BSN, RN, CCRN, CPHQ ,&nbsp;Susan Berman RN, CPHQ ,&nbsp;Angela Ortiz BSN, RN ,&nbsp;Christelle Cossais MHSC, BS, RN, NHE ,&nbsp;Christopher D. Mangum CSSBB","doi":"10.1016/j.cppeds.2023.101464","DOIUrl":"10.1016/j.cppeds.2023.101464","url":null,"abstract":"<div><p>A palpable pulse on organizational culture is imperative for allowing senior leadership to understand the current state and use this as a starting point to measure the gap between the current state and where the organization should be to meet strategic goals related to quality and safety. Knowledge gleaned from causal analysis and coding of safety events provides the organization with that information. Our organization was unknowingly making decisions on a small quantity of coded and classified events, which led to mistakes on our journey to becoming a high-reliability organization.</p><p>To remedy this, the Quality and Safety Team improved the user interface of the event reporting system and created standard work for all frontline staff, physicians, area managers and senior leaders. After several interventions, we reduced the time between reported events and documented resolution by 15.28% and increased the quantity of coded and classified safety events tenfold. These changes improved our organization's ability to make better informed decisions and plot a more precise course on the journey to becoming a high-reliability organization.</p></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048289","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":"Navigating quality and safety in your health system: understanding the alphabet soup","authors":"John W. Harrington MD ,&nbsp;Tom Cholis MD ,&nbsp;Kathryn Colacchio MD","doi":"10.1016/j.cppeds.2023.101460","DOIUrl":"10.1016/j.cppeds.2023.101460","url":null,"abstract":"<div><p>Entering any new healthcare system today requires thorough knowledge about its quality and safety structure and culture. Learning that language is generally the first step in gaining a better understanding of how systems function. This overview of common mnemonics in the quality and safety world will provide the reader with better comprehension of their quality systems within their institutions. Healthcare providers should understand how patient safety organizations were established and the importance of our safety event classification system, along with the ability to recognize gaps in care that highlight opportunities for improvement. In addition, this review provides explanations of error prevention tools used every day to help new colleagues communicate better and share situational awareness to keep patients safe. Lastly, utilization of standard quality improvement tools can facilitate quality improvement projects and assist all healthcare systems to become highly reliable organizations.</p></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296344","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":"Issue 1 introduction to pediatric healthcare quality and safety with a practical approach to quality improvement education","authors":"John W. Harrington MD","doi":"10.1016/j.cppeds.2023.101458","DOIUrl":"10.1016/j.cppeds.2023.101458","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399990","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":"Journey to STEEEP healthcare: A focus on systems through a patient's experience","authors":"Christopher D. Mangum CSSBB","doi":"10.1016/j.cppeds.2023.101461","DOIUrl":"10.1016/j.cppeds.2023.101461","url":null,"abstract":"<div><p><span>Healthcare systems continue to struggle with providing safe, timely, effective, efficient, equitable and patient-centered (STEEEP) care. Upon audit by clinicians, treatment processes such as those completed following </span>clinical pathways<span> appear to manage care safely. However, when reviewing the treatment process through the patient and/or their family's lens, the experience is quite different. This article will use a vignette detailing care provided in a primary care physician's office along with the patient's outpatient testing experience to reveal opportunities for improvement, a glimpse into the patient's experience and share methods for achieving STEEEP healthcare.</span></p></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300435","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}