Ceftriaxone use for acute otitis media: Associated factors in a large U.S. primary care population.

Background: Clinicians in the authors' primary care academic practice have anecdotally perceived an increased use of intramuscular (IM) ceftriaxone, particularly for otitis-conjunctivitis in recent years (pre-pandemic). Increasing rates of ceftriaxone administration for acute otitis media (AOM) may be an important marker of antimicrobial resistance.

Objective: We aimed to characterize the population of patients who received ceftriaxone for treatment of AOM, testing our hypothesis that patients with concomitant conjunctivitis would have increased rates of ceftriaxone receipt.

An educational intervention to facilitate appropriate subspecialty referrals: a study assessing resident communication skills.

Background: Our goal was to improve pediatric residents' advanced communication skills in the setting of referral to address the entrustable professional activity of subspecialty referral identified by the American Board of Pediatrics. To accomplish this aim, we created a referral and consultation curriculum to teach and assess core communication skills in subspecialty referral involving an adolescent with syncope, an anxiety-provoking symptom that is rarely associated with serious pathology.

Methods: We utilized blended multimodal educational interventions to improve resident communication skills in referral of patients.

Children's Hospital Ambulatory Response to the 2019 Novel Coronavirus Disease (COVID-19) Pandemic.

The 2019 novel coronavirus disease (COVID-19) pandemic produced an abrupt and near shutdown of nonemergent patient care. Children's National Hospital (CNH) mounted a multidisciplinary, coordinated ambulatory response that included supply chain management, human resources, risk management, infection control, and information technology. To ensure patient access, CNH expanded telemedicine and instituted operational innovations for outpatient procedures.

Promoting Judicious Primary Care Referral of Patients with Chest Pain to Cardiology: A Quality Improvement Initiative.

Objective: To decrease referrals to cardiology of patients ages 7 to 21 years with low-probability cardiac pathology who presented to primary care with chest pain by 50% within 24 months.

Study Design: A multidisciplinary team designed and implemented an initiative consisting of 1) a decision support tool (DST), 2) educational sessions, 3) routine feedback to improve use of referral criteria, and 4) patient family education. Four pediatric practices, comprising 34 pediatricians and 7 nurse practitioners, were included in this study.

Results of Testing Children for Severe Acute Respiratory Syndrome Coronavirus-2 Through a Community-based Testing Site.

Objective: To describe the demographics, clinical features, and test results of children referred from their primary provider for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the community setting.

Study Design: Retrospective cross-sectional study of children ≤22 years of age who were tested for SARS-CoV-2 at a community-based specimen collection site in Washington, DC, affiliated with a large children's hospital between March 21 and May 16, 2020.

Results: Of the 1445 patients tested at the specimen collection site for SARS-CoV-2 virus, 408 (28.

Tools for Learning About the Referral and Consultation Process for Pediatric Residents.

Management of referral and consultation is an entrustable professional activity for pediatric residents; however, few tools exist to teach these skills. We designed and implemented tools to prompt discussion, feedback, and reflection about the process of referral, notably including the family's perspective.

Ethiopian medical schools' rapid scale-up to support the government's goal of universal coverage.

In 2003, Ethiopia declared it would pursue the goal of universal primary health coverage. In response to the critical shortage of human resources for health care, the government decided to rapidly increase the training of health workers to provide basic services, including health education, disease prevention, and family health services primarily to rural areas. This approach, which became known as the "flooding strategy," was extended in 2005 to include medical doctors.

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

Background: Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children.

Observation of resident clinical skills: outcomes of a program of direct observation in the continuity clinic setting.

Objective: To assess the feasibility of a new multi-institutional program of direct observation and report what faculty observed and the feedback they provided.

Methods: A program of direct observation of real patient encounters was implemented in 3 pediatric residency programs using a structured clinical observation (SCO) form to document what was observed and the feedback given. Outcome variables included the number of observations made, the nature of the feedback provided, resident attitudes about direct observation before and after implementation, and the response of the faculty.

Medical schools in sub-Saharan Africa.

Small numbers of graduates from few medical schools, and emigration of graduates to other countries, contribute to low physician presence in sub-Saharan Africa. The Sub-Saharan African Medical School Study examined the challenges, innovations, and emerging trends in medical education in the region. We identified 168 medical schools; of the 146 surveyed, 105 (72%) responded.

Intervention to reduce parental bypass of community pediatric primary health facilities in asmara, eritrea.

Objective: To reduce direct parental referral of low acuity ill pediatric patients to the outpatient facilities of a nation's only pediatric referral hospital.

Patients And Methods: Longitudinal monitoring of outpatient visits at Orotta Children's Hospital (OCH) and primary health facilities (PHFs) following implementation of an intervention designed in response to information provided by parents and health-care providers. Parental surveys were undertaken before and after exposure to the intervention to assess effects on knowledge, attitudes, and behavioral intentions.

Randomized trial of brief office-based interventions to reduce adolescent alcohol use.

Objective: To determine whether office-based interventions change adolescents' alcohol beliefs and alcohol use.

Design: Randomized, controlled trial.

Setting: Five managed care group practices in Washington, DC.

Effect of patient priming and primary care provider prompting on adolescent-provider communication about alcohol.

Objective: To determine whether priming adolescent patients to discuss alcohol with their primary care providers and prompting providers to discuss alcohol increases adolescent-provider communication about alcohol.

Design: Randomized controlled trial.

Setting: Five managed care group practices in Washington, DC.