The Child Health PSO at 10 Years: An Emerging Learning Network.

Introduction: The 2005 Patient Safety and Quality Improvement Act, actualized as a Learning Network (LN), has enabled the Child Health Patient Safety Organization (PSO) to play a vital and novel role in improving the quality and safety of care. This article describes the Child Health PSO and proposes PSOs as a new construct for LNs.

Methods: A PSOs ability to affect patient care depends on member organizations' integration of PSO output into their individual Learning Healthcare Systems.

Teaching and Assessing Communication Skills in Pediatric Residents: How Do Parents Think We Are Doing?

Objective: Curricula designed to teach and assess the communication skills of pediatric residents variably integrates the parent perspective. We compared pediatric residents' communication skills in an objective structured clinical exam (OSCE) case as assessed by Family Faculty (FF), parents of pediatric patients, versus standardized patients (SP).

Methods: Residents participated in an OSCE case with a SP acting as a patient's parent.

A new framework for quality partnerships in Children's Hospitals.

Children's hospitals and their affiliated departments of pediatrics often pursue separate programs in quality and safety; by integrating these programs, they can accelerate progress. Hospital executives and pediatric department chairs from 14 children's hospitals have been exploring practical approaches for integrating quality programs. Three components provide focus: (1) alignment of quality priorities and resources across the organizations; (2) education and training for physicians in the science of improvement; and (3) professional development and career progression for physicians in recognition of quality-improvement activities.

A novel error-reporting tool in pediatric intensive care.

Patient safety is a critical component of the U.S. healthcare system: thousands of people, including children, die or are injured yearly as a result of medical error.

Journey toward meaningful pediatric quality metric reporting: the Texas experience.

Working under a mandate for public reporting, children's hospitals in Texas joined in a partnership with the state with the intent of working toward providing meaningful assessment of the quality of pediatric inpatient care. This article summarizes a journey of nearly 2 years undertaken to review currently available quality measures and arrive at interagency consensus for the reporting of pediatric quality and clinical outcomes in Texas. Public reporting has been approached with great divergence across the states.

Off-label drug use in hospitalized children.

Objectives: To describe the magnitude of off-label drug use, to identify drugs most commonly used off-label, and to identify factors associated with off-label drug use in children hospitalized in the United States.

Design: Retrospective cohort study.

Setting: Administrative database containing inpatient resource utilization data from January 1 to December 31, 2004, from 31 tertiary care pediatric hospitals in the United States.

Regional variation in ICU care for pediatric patients with asthma.

Objective: To determine adherence to guidelines for severe asthma care and evaluate regional variability in practice among pediatric intensive care units (PICU).

Study Design: A retrospective cohort study of children treated for asthma in a PICU during 2000 to 2003. We utilized the Pediatric Health Information System (PHIS) database to identify patients and determine use of asthma therapies when patients did not improve with standard therapy (inhaled beta-agonists and systemic corticosteroids).

Amino acid clearance during acute metabolic decompensation in maple syrup urine disease treated with continuous venovenous hemodialysis with filtration.

Objective: Assessment of amino acid clearances by continuous venovenous hemodialysis with filtration in treatment of a metabolic decompensation in acute maple syrup urine disease.

Design: Single patient assessment.

Setting: Pediatric intensive care unit.