Monitoring the health of the work environment with a daily assessment tool: the REAL - Relative Environment Assessment Lens - indicator.

Background: Evidence shows that the health of the work environment impacts staff satisfaction, interdisciplinary communication, and patient outcomes. Utilising the American Association of Critical-Care Nurses' Healthy Work Environment standards, we developed a daily assessment tool.

Methods: The Relative Environment Assessment Lens (REAL) Indicator was developed using a consensus-based method to evaluate the health of the work environment and to identify opportunities for improvement from the front-line staff.

Utility of a dedicated pediatric cardiac anticoagulation program: the Boston Children's Hospital experience.

Congenital heart disease is the leading cause of stroke in children. Warfarin therapy can be difficult to manage safely in this population because of its narrow therapeutic index, multiple drug and dietary interactions, small patient size, high-risk cardiac indications, and lack of data to support anticoagulation recommendations. We sought to describe our institution's effort to develop a dedicated cardiac anticoagulation service to address the special needs of this population and to review the literature.

Development of a charge adjustment model for cardiac catheterization.

A methodology that would allow for comparison of charges across institutions has not been developed for catheterization in congenital heart disease. A single institution catheterization database with prospectively collected case characteristics was linked to hospital charges related and limited to an episode of care in the catheterization laboratory for fiscal years 2008-2010. Catheterization charge categories (CCC) were developed to group types of catheterization procedures using a combination of empiric data and expert consensus.

Paediatric nurse practitioner managed cardiology clinics: patient satisfaction and appointment access.

Aim: This article summarizes a comparative study of patient/family satisfaction and appointment wait times in physician managed vs. paediatric nurse practitioner managed cardiology clinics.

Background: Appointment wait times exceeded 40 days in the outpatient cardiology department at a children's hospital.

Improved bed use with creation of a short-stay unit in a cardiac catheterization recovery room.

Objective: To solve a capacity problem in a pediatric cardiovascular program, a 5- bed short-stay unit was created in the cardiac catheterization recovery room area within a 6-week timeframe. We describe the problem, solution, and early results in hospital performance and patient outcomes.

Methods: Data were reviewed for 183 patients who underwent various cardiac catheterization procedures and recovered overnight in the cardiac short-stay unit during the first 4 months of operation.