Patient engagement: Changing pediatric practice to improve patient care.

Twenty-first century health care has evolved into a patient-centred enterprise that has changed the relationship between doctors and patients. Society now sets a high expectation for clinicians not only to impart knowledge to people about their illnesses and prescribe treatments to improve their clinical conditions but also to work with patients to ensure that the treatments are acceptable to ensure the patients' adherence to the recommendations. Most physicians are not trained for this change, but the principles of patient engagement can help clinicians meet these new challenges and perform well on measures of patient satisfaction and compliance with care recommendations.

How (and why) do quality improvement professionals measure performance?

The era of value-based care has engulfed healthcare delivery systems around the world. Pediatricians are especially challenged by constrained resources for providing care to our vulnerable population, and methods for achieving value for children through improved quality and reduced cost of care are crucial for success. This paper examines the use of measures to determine the two components of the value proposition: quality and cost.

Effect of a resident physician educational program on pediatric emergency department pharmacy interventions and medication errors.

Purpose: To determine the effects of a resident physician educational program in a pediatric emergency department (ED) on pharmacy interventions and medication errors, particularly dose adjustments, order clarifications, and adverse drug events (ADE).

Methods: The ED pharmacist recorded all interventions and medication errors on weekdays from 3 to 11 pm during a 9-month period, consisting of a preobservational (Quarter 1), observational (Quarter 2), and interventional (Quarter 3) phases. Program implementation occurred in Quarter 3, with an initial 3-hour lecture during the ED orientation, followed by daily patient case discussions.

Building communication between professionals at children's specialty hospitals and the medical home.

Objective: Build a quality improvement (QI) intervention to improve communication between a children's specialty hospital and referring primary care providers (PCPs).

Methods: A network of charitable children's hospitals identified improving communication as a systemwide goal. At one model hospital, we used qualitative telephone interviewing of hospital specialists and staff, and referring PCPs, to characterize the communication system and identify potential improvements.

Evidence-based analysis of removal of orthopaedic implants in the pediatric population.

Background: Requested project of the Pediatric Orthopaedic Society of North America Evidenced-Based Medicine Committee.

Methods: The English literature was systematically reviewed for scientific evidence supporting or disputing the common practice of elective removal of implants in children.

Results: Several case series reported implant removal, but none contained a control group with retained implants.

A prospective evaluation of the WeeFIM in patients with cerebral palsy undergoing orthopaedic surgery.

Purpose: Although frequently used in pediatric rehabilitation settings, the WeeFIM has not been tested in surgical pediatric orthopaedic patients.

Methods: The WeeFIM was administered to patients with surgical cerebral palsy at defined intervals preoperatively and at both 6 and 12 months postoperatively. The age-adjusted change scores from baseline to follow-up were tested both parametrically and nonparametrically.

Computer equipment used in patient care within a multihospital system: recommendations for cleaning and disinfection.

Computer hardware has been implicated as a potential reservoir for infectious agents. Leaders of a 22-hospital system, which spans North America and serves pediatric patients with orthopedic or severe burns, sought to develop recommendations for the cleaning and disinfection of computer hardware within its myriad patient care venues. A task force comprising representatives from infection control, medical affairs, information services, and outcomes management departments was formed.

Case study: using control charts to track physician productivity.

Learn how control charts are being used to gauge physician productivity in a Shriners hospital in Kentucky. The charts provide a fair and accurate analysis that doctors appreciate.