Evaluation of an Innovative Model of Care for a Limited-Stay Pediatric Unit.

Information about pediatric observation and limited-stay unit design and function is lacking in the literature. A quality improvement approach was used to create new care processes on an inpatient unit within a large children's hospital. Outcomes included the use of advanced practice nurse patient care management, creation of 30 clinical pathways to model care, and consistent and faster transfer from emergency department to inpatient unit, resulting in high-level parent and patient satisfaction and decreased nursing turnover.

Outcomes and costs associated with hospitalist comanagement of medically complex children undergoing spinal fusion surgery.

Objective: The goal of this study was to assess outcomes and costs associated with hospitalist comanagement of medically complex children undergoing spinal fusion surgery for neuromuscular scoliosis.

Methods: A hospitalist comanagement program was implemented at a children's hospital. We conducted a retrospective case series study of patients during 2003-2008 to compare clinical and cost outcomes for 87 preimplementation patients, 40 patients during a partially implemented program, and 80 patients during a fully implemented program.