Enhancing Hospital Throughput: A Multidisciplinary Approach to Facilitating Discharges in a Pediatric Setting.

Introduction: Recent postpandemic respiratory viral surges have highlighted challenges in inpatient capacity at children's hospitals. Our hospital identified a key bottleneck affecting our ability to accommodate patients: afternoon discharge clustering. We sought to improve throughput efficiency by increasing the percentage of patients discharged outside peak hours.

Improving Time to Completion of Medical Student Clerkship Evaluations.

Background And Objectives: Medical student clinical clerkship evaluations provide feedback for growth and contribute to the clerkship grade and the student's residency application. Their importance is expected to increase even more with the recent change of the US Medical Licensing Examination Step 1 to a pass/fail designation. Timely completion of medical student clerkship evaluations is a problem.

Disparities and Biases in Food Insecurity Screening Among Admitted Children.

Background And Objectives: Food insecurity (FI) has increasingly become a focus for hospitalized patients. The best methods for screening practices, particularly in hospitalized children, are unknown. The purpose of the study was to evaluate results of an electronic medical record (EMR) embedded, brief screening tool for FI among inpatients.

Demographic and clinical characteristics of pediatric COVID-19 in Arkansas: March-December 2020.

The COVID-19 pandemic reached the United States in early 2020 and spread rapidly across the country. This retrospective study describes the demographic and clinical characteristics of 308 children presenting to an Arkansas Children's emergency department (ED) or admitted to an Arkansas Children's hospital with COVID-19 in the first 10 months of the COVID-19 pandemic, prior to the emergence of clinically significant variants and available vaccinations. Adolescents aged 13 and older represented the largest proportion of this population.

Food Insecurity Screening of Hospitalized Patients: A Descriptive Analysis.

Objectives: The purpose of this study is to describe an advocacy effort to implement a food insecurity (FI) screening during hospital admission and describe characteristics of hospitalized patients with household FI.

Methods: This is a descriptive study after the implementation of FI screening at a quaternary-care children's hospital in the Southeastern United States between August 2020 and April 2021. The Hunger Vital Sign, a 2-question screening tool for FI, was added to the intake questionnaire performed on inpatient admissions.

De-escalation of High-flow Respiratory Support for Children Admitted with Bronchiolitis: A Quality Improvement Initiative.

Unlabelled: Bronchiolitis is the most common cause for hospitalization in the first year of life, with hypoxemia and acute respiratory failure as major determinants leading to hospitalization. In addition, the lack of existing guidelines for weaning and discontinuing supplemental oxygen, including high-flow nasal cannula, may contribute to prolonged hospitalization and increased resource utilization.

Methods: This single-center quality improvement initiative assessed the effect of implementing a standardized care process for weaning and discontinuing high-flow oxygen for patients hospitalized with bronchiolitis.

Utilization of Monitored Beds for Children Admitted With Unintentional Poisonings.

Objectives: Children with unintentional poisonings (UPs) are frequently admitted to monitored beds (MBs), though most require minimal interventions. We aimed to (1) describe clinical factors and outcomes for children admitted for UPs and (2) identify clinical factors associated with MB placement.

Methods: In this single-center retrospective cohort study, we studied patients younger than 6 years admitted from the emergency department (ED) for UPs over a 5-year period to a quaternary-care children's hospital.

Acute Kidney Injury Among Children Admitted With Viral Rhabdomyolysis.

Background: Infectious etiologies cause a large portion of pediatric rhabdomyolysis. Among pediatric patients with rhabdomyolysis, it is unknown who will develop acute kidney injury (AKI). We sought to test the hypothesis that a viral etiology would be associated with less AKI in children admitted with rhabdomyolysis than a nonviral etiology.

Predictors of Potentially Unnecessary Transfers to Pediatric Emergency Departments.

Objectives: With soaring US health care costs, identifying areas for reducing cost is prudent. Our objective was to identify the burden of potentially unnecessary pediatric emergency department (ED) transfers and factors associated with these transfers.

Methods: We performed a retrospective analysis of Pediatric Hospital Information Systems data.

Residential instability, neighborhood deprivation, and pediatric asthma outcomes.

Introduction: Limited work has directly compared the role of different neighborhood factors or examined their interactive effects on pediatric asthma outcomes. Our objective was to quantify the main and interactive effects of neighborhood deprivation and residential instability (RI) on pediatric asthma outcomes.

Methods: We conducted a retrospective cross-sectional study of patients with a primary diagnosis of asthma hospitalized at a tertiary care pediatric hospital.

What Defines an Honors Student? Survey of Pediatric and Internal Medicine Faculty Perspectives.

Objective: Although considerable emphasis is placed on the attainment of honors in core medical school clerkships, little is known about what student characteristics are used by attending physicians to earn this designation. The purpose of this study was to evaluate what values and characteristics that attending physicians consider important in the evaluation of Pediatrics and Internal Medicine clerkship students for clinical honors designation.

Methods: This cross-sectional survey study was framed around Accreditation Council for Graduate Medical Education (ACGME) competencies.

Splenic infarction from vascular torsion in a child with normal splenic anatomy.

This is a case of an 8-year-old, Caucasian boy with a complex prior medical history who presented with worsening, acute, left-sided abdominal pain and fever after empiric treatment for a urinary tract infection. Repeat urinalysis was negative for infection. A renal ultrasound assessing for occult perinephric abscess or nephronia revealed normal kidneys but found a tubular structure adjacent to the left kidney.

Characteristics of Rural Children Admitted to Pediatric Hospitals.

Background And Objectives: Delivering high-quality care to children living in rural areas can be challenging. Compared with nonrural children, rural children often experience worse health outcomes. We assessed characteristics and hospitalizations of rural children admitted to US children's hospitals in 2012.

Demographic predictors of leukotriene antagonist monotherapy among children with persistent asthma.

Objective: To describe the children with persistent asthma receiving non-preferred controller therapy in the form of leukotriene receptor antagonist monotherapy (LTRAM).

Study Design: In this cross-sectional study, we analyzed 2007-2009 South Carolina Medicaid data of children aged 2- to 18 years with persistent asthma, defined by Healthcare Effectiveness Data and Information Set (HEDIS). Those without either LTRAM or inhaled corticosteroids (ICS) were excluded.

High-fidelity simulation enhances pediatric residents' retention, knowledge, procedural proficiency, group resuscitation performance, and experience in pediatric resuscitation.

Objective: The goal of this study was to assess the effect of high-fidelity simulation (HFS) pediatric resuscitation training on resident performance and self-reported experience compared with historical controls.

Methods: In this case-control study, pediatric residents at a tertiary academic children's hospital participated in a 16-hour HFS resuscitation curriculum. Primary outcome measures included cognitive knowledge, procedural proficiency, retention, and self-reported comfort and procedural experience.