The Development and Piloting of the Ambulatory Electronic Health Record Evaluation Tool: Lessons Learned.

Background: Substantial research has been performed about the impact of computerized physician order entry on medication safety in the inpatient setting; however, relatively little has been done in ambulatory care, where most medications are prescribed.

Objective: To outline the development and piloting process of the Ambulatory Electronic Health Record (EHR) Evaluation Tool and to report the quantitative and qualitative results from the pilot.

Methods: The Ambulatory EHR Evaluation Tool closely mirrors the inpatient version of the tool, which is administered by The Leapfrog Group.

Developing and Testing the Health Care Safety Hotline: A Prototype Consumer Reporting System for Patient Safety Events.

This article describes the design, development, and testing of the Health Care Safety Hotline, a prototype consumer reporting system for patient safety events. The prototype was designed and developed with ongoing review by a technical expert panel and feedback obtained during a public comment period. Two health care delivery organizations in one metropolitan area collaborated with the researchers to demonstrate and evaluate the system.

Implementation and evaluation of a prototype consumer reporting system for patient safety events.

Objective: No methodologically robust system exists for capturing consumer-generated patient safety reports. To address this challenge, we developed and pilot-tested a prototype consumer reporting system for patient safety, the Health Care Safety Hotline.

Design: Mixed methods evaluation.

Characteristics of medication use during pediatric medical emergency team events and the role of a pharmacist-provided medication supply.

Objectives: To determine the type and frequency of and indications for medications used during pediatric medical emergency team (PMET) events and to describe a PMET pharmacist training model, creation of a standardized "pharmacist PMET supply," and the pharmacist's role in implementation and ongoing improvement of a PMET.

Methods: This is a retrospective observational cohort study of 210 PMET events in 172 patients in a tertiary care, academic pediatric hospital, from September 15, 2005, to September 15, 2007. We focused on the types and sources of medications used during PMET events.

Continuity-structured clinical observations: assessing the multiple-observer evaluation in a pediatric resident continuity clinic.

Objectives: The continuity-structured clinical observation tool was developed and used to conduct a multiple-observer evaluation to assess residents in the core competency areas of patient care, interpersonal and communication skills, and professionalism. The objectives were to assess pediatric resident performance in a continuity clinic by using direct observation and to compare evaluations among preceptors, residents, and parents.

Methods: Pediatric residents in a large continuity clinic participated between August and December 2005.

Patient safety rounds in a pediatric tertiary care center.

Background: Patient safety rounds were implemented in a pediatric tertiary care setting. Completed patient safety issues from three years of pediatric patient safety rounds and nine months of pediatric surgical safety rounds were analyzed. Completed issues were categorized into both Modified Vincent and University HealthSystem Consortium (UHC) categorization schemes to compare and contrast their attributes.

Transition from a traditional code team to a medical emergency team and categorization of cardiopulmonary arrests in a children's center.

Objectives: To study the effect of an intervention on prevention of respiratory arrest and cardiopulmonary arrest (CPA) and to characterize ward CPAs by preceding signs and symptoms and initial cardiac rhythm.

Design: A before-and-after interventional trial (12 months preintervention and 12 months postintervention).

Setting: A tertiary care, academic children's hospital.

Maternal and child factors affecting high-volume pediatric emergency department use.

Objective: To describe maternal and child characteristics associated with high-volume nonurgent pediatric emergency department (ED) use.

Methods: We surveyed female caregivers of children aged 1 to 14 years who were brought to the ED at an urban medical center for nonurgent conditions. We analyzed characteristics associated with low-volume (1 ED visit) or high-volume (> or = 2 ED visits) use within the past year.

Epidemiology of pediatric emergency department use at an urban medical center.

Objectives: Dramatic increases in emergency department (ED) use contribute to rising healthcare costs and decrease continuity of care in the United States. Yet little is known about the acuity, frequency of visits, and demographic characteristics of children using the ED. This study examines general demographic trends over a 3-year period and examines whether there are factors associated with varying acuity at an urban academic pediatric ED.

Maternal depression: an old problem that merits increased recognition by child healthcare practitioners.

Purpose Of Review: Maternal depression is an old problem that has received heightened public attention in recent years. Although the prevalence of maternal depression remains considerable, healthcare providers continue to underrecognize and undertreat women with this condition. Currently there is increasing political as well as international support for further study to understand depression and its impact on those directly and indirectly involved.