Multidisciplinary handoffs improve perceptions of communication.

Background: Communication errors during handoffs are a leading cause of sentinel events. The Accreditation Council for Graduate Medical Education 2011 duty hour standards (DHS) increase the frequency of handoffs.

Objective: The goal of this study was to determine if a multidisciplinary group handoff bundle improves communication while working within the 2011 DHS.

Effects of the 2011 duty hour restrictions on resident education and learning from patient admissions.

Objective: In July 2011, new duty hour limits for resident physicians were instituted to address concerns about the effects of sleep deprivation on patient care and trainee experience. We sought to evaluate potential educational impacts of these duty hour changes with regard to learning and frequency of attending interactions during patient admissions.

Methods: Forty-nine residents on general pediatric teams participated in a prospective observational cohort study.

Oral antibiotics at discharge for children with acute osteomyelitis: a rapid cycle improvement project.

Background: Substantial evidence demonstrates comparable cure rates for oral versus intravenous therapy for routine osteomyelitis. Evidence adoption is often slow and in our centre virtually all patients with osteomyelitis were discharged on intravenous therapy.

Objective: For patients with acute osteomyelitis admitted to the hospital medicine service, we aimed to increase the proportion of cases discharged on oral antibiotics to at least 70%.

Pediatric hospitalist perceptions of the impact of duty hour changes on education and patient care.

Objective: The goal of this study was to measure the impact of the new 2011 Accreditation Council for Graduate Medical Education duty hour standards (DHS) on education, patient care, and overall satisfaction as perceived by pediatric hospitalist faculty.

Methods: We undertook a nonrandomized but controlled study of 23 pediatric hospitalist faculty members during a trial of the new DHS in 2011. During the intervention (January), residents piloted schedules that complied with the new DHS, and in the control period (February), resident schedules complied with previous DHS.

Effect of a face sheet tool on medical team provider identification and family satisfaction.

Resident duty hour restrictions may expose families to more trainees during hospitalization and hinder recognition of medical team members. This may negatively impact family satisfaction. Our study sought to determine the effects of a face sheet tool on families' identification and satisfaction rating of the medical team.

Evaluating the impact of interactive and entertaining educational conferences.

Adult learning theory suggests that meaningful engagement impacts learning. To evaluate the impact of resident-led interactive conferences on satisfaction, engagement and knowledge acquisition. A prospective study at a paediatric academic institution compared educational conferences in two formats.

Rapid adoption of Lactobacillus rhamnosus GG for acute gastroenteritis.

Background And Objectives: A 2007 meta-analysis showed probiotics, specifically Lactobacillus rhamnosus GG (LGG), shorten diarrhea from acute gastroenteritis (AGE) by 24 hours and decrease risk of progression beyond 7 days. In 2005, our institution published a guideline recommending consideration of probiotics for patients with AGE, but only 1% of inpatients with AGE were prescribed LGG. The objective of this study was to increase inpatient prescribing of LGG at admission to >90%, for children hospitalized with AGE, within 120 days.

Survey of academic pediatric hospitalist programs in the US: organizational, administrative, and financial factors.

Background: Many pediatric academic centers have hospital medicine programs. Anecdotal data suggest that variability exists in program structure.

Objective: To provide a description of the organizational, administrative, and financial structures of academic pediatric hospital medicine (PHM).

Improved documentation and care planning with an asthma-specific history and physical.

Objective: The objective was to determine the effect of an electronic asthma-specific inpatient history and physical (H&P) template on documented history and improvements in care plans.

Methods: This was a before-after comparison of history and care plan documentation following implementation of a new H&P template. The template was implemented in May 2011.

Utilizing improvement science methods to improve physician compliance with proper hand hygiene.

Objective: In 2009, The Joint Commission challenged hospitals to reduce the risk of health care-associated infections through hand hygiene compliance. At our hospital, physicians had lower compliance rates than other health care workers, just 68% on general pediatric units. We used improvement methods and reliability science to increase compliance with proper hand hygiene to >95% by inpatient general pediatric teams.