Learning from Each Other: A Multisite Collaborative to Reduce Electrolyte Testing.

Unlabelled: Inpatient electrolyte testing rates vary significantly across pediatric hospitals. Despite evidence that unnecessary testing exists, providers still struggle with reducing electrolyte laboratory testing. We aimed to reduce serum electrolyte testing among pediatric inpatients by 20% across 5 sites within 6 months.

Evaluating Pediatric Sepsis Definitions Designed for Electronic Health Record Extraction and Multicenter Quality Improvement.

Objectives: To describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and the identified patients; evaluate the definition using a published framework for evaluating sepsis definitions.

Design: Observational cohort.

Setting: Multicenter quality improvement collaborative of 46 hospitals from January 2017 to December 2018, excluding neonatal ICUs.

Risk of Vascular Access Infection Associated With Buttonhole Cannulation of Fistulas: Data From the National Healthcare Safety Network.

Rationale & Objective: Compared with conventional (rope-ladder cannulation [RLC]) methods, use of buttonhole cannulation (BHC) to access arteriovenous fistulas (AVFs) may be associated with increased risk for bloodstream infection and other vascular access-related infection. We used national surveillance data to evaluate the infection burden and risk among in-center hemodialysis patients with AVFs using BHC.

Study Design: Descriptive analysis of infections and related events and retrospective observational cohort study using National Healthcare Safety Network (NHSN) surveillance data.

An evidence-based strategy to achieve equivalency and interoperability for social-behavioral determinants of health assessment, storage, exchange, and use.

The interoperable exchange of social-behavioral determinants of health data is challenging due to complex factors including multiple recommendations, multiple tools with varying domains, scoring, and cutpoints, and lack of terminology code sets for storing assessments and findings. This article describes a strategy that permits scoring by social-behavioral determinants of health domain to create interoperability and equivalency across tools, settings, and populations. The three-tier scoring strategy converts social-behavioral determinants of health data to (1) be used immediately at point of care by identifying social needs or social risk factors, (2) be consumed within analytics and algorithms and for secondary analysis, and (3) produce total scores that reflect social determinant burden and behavioral determinant burden across populations and settings within a healthcare system.

Capturing health literacy assessment in the electronic health record through evidence-based concept creation: A review of the literature and recommendations for action.

Health literacy is the capacity to understand and act upon health-related information and navigate the healthcare system. Published evidence demonstrates a relationship between health literacy and health status. Because of this, there are increasingly calls for a health literacy assessment to be collected and stored in the electronic health record for use by the healthcare team.

Determining Palliative Care Penetration Rates in the Acute Care Setting.

Context: Intermountain Healthcare, in collaboration with Cerner Corporation, developed a hospital-based electronic palliative care algorithm.

Objectives: This study aims to improve identification of patients who would benefit from palliative care services, and calculate palliative care penetration rates.

Methods: This study used a mixed-methods nonrandomized retrospective study design.

A Concise Set of Structure and Process Indicators to Assess and Compare Antimicrobial Stewardship Programs Among EU and US Hospitals: Results From a Multinational Expert Panel.

OBJECTIVES To develop common indicators, relevant to both EU member states and the United States, that characterize and allow for meaningful comparison of antimicrobial stewardship programs among different countries and healthcare systems. DESIGN Modified Delphi process. PARTICIPANTS A multinational panel of 20 experts in antimicrobial stewardship.