Collaboration to Reduce Sudden Unexpected Infant Death With Child Fatality Review and Outreach.

Sudden unexpected infant death (SUID) is the leading cause of postneonatal infant mortality in the United States, with disproportionately high rates in Baltimore City and Baltimore County in Maryland. This Advocacy Case Study describes the collaboration between the City and County Child Fatality Review teams to decrease infant mortality. B'more for Healthy Babies, formed in 2009 by the Bureau of Maternal Child Health in Baltimore City with the goal of reducing infant mortality through policy change, service improvements, community mobilization, and behavior change has had a sustained effort to respond to SUID.

DiabetesWise: An innovative approach to promoting diabetes device awareness.

Background: DiabetesWise is an unbranded, data-driven online resource that tailors device recommendations based on preferences and priorities of people with insulin-requiring diabetes. The objective of this study is to examine whether DiabetesWise increases uptake of diabetes devices, which are empirically supported to improve glycemic and psychosocial outcomes.

Methods: The sample included 458 participants (M  = 37.

Challenges Meeting Training Requirements in the Care of Children in Family Medicine Residency Programs: A CERA Study.

Background And Objective: In 2014, the Accreditation Council for Graduate Medical Education (ACGME) implemented numeric requirements for family medicine (FM) pediatric patient encounters. Impact on residency programs is unclear. We aimed to identify any difficulties faced by FM program directors (PDs) meeting these numeric requirements.

Feasibility of video observed therapy to support controller inhaler use among children in West Baltimore.

Objective: To assess feasibility of a novel video directly observed therapy (DOT)-based digital asthma program intended to support correct inhaled corticosteroid (ICS) use among children.

Methods: We conducted a 60-day pilot study among patients 2-18 years attending a primary care clinic with prescribed ICS and sub-optimally controlled asthma (recent hospitalization, ICS nonadherence, frequent rescue inhaler use, therapy escalation, or Asthma Control Test <20). Participants used a mobile application to receive reminders, submit videos of ICS doses (video DOT), and receive asynchronous feedback on adherence and inhaler technique.

The Future of Inpatient Community Hospital Care: Is There One?

Community hospital inpatient pediatric programs face a variety of challenges including financial instability, variable censuses, difficulty maintaining qualified staff, and a lack of focus for the hospital. With the addition of new payment models, such as bundled payments and global budgets, along with a global pandemic, the future of community hospital pediatric inpatient care is uncertain at best. In this article we summarize the challenges, opportunities, and potential solutions to maintaining high-quality care for hospitalized children in community hospitals.

A Hospital-Based Initiative to Reduce Postdischarge Sudden Unexpected Infant Deaths.

Background And Objectives: Sudden unexpected infant deaths (SUID) most often occur because infants are placed in unsafe sleep environments. Although authors of previous literature have demonstrated that parents who receive comprehensive safe sleep education increase knowledge and intention to place children in safe sleep environments, no studies have demonstrated improved outcomes. We describe the development of a hospital-based newborn SUID risk reduction quality improvement project and its effectiveness in reducing subsequent SUIDs in a community using linked outcome data from local Child Fatality Review Teams.

Changes in Asthma Maintenance Therapy Prescribing Patterns Following the 2006 Long-acting β-Agonist FDA Drug Warning.

Purpose: The US Food and Drug Administration issued a boxed warning on all products containing a long-acting β-agonist (LABA) in March 2006, after the findings from a trial suggested an increased risk for death in patients treated with salmeterol monotherapy. Almost nothing is known about the impact of this warning on LABA prescribing patterns or on clinicians' approaches to asthma maintenance therapy.

Methods: A cohort of asthmatic adults on LABA therapy was retrospectively identified from a Baltimore-area Medicaid data warehouse.

Improving infant sleep safety through a comprehensive hospital-based program.

We evaluated a comprehensive hospital-based infant safe sleep education program on parental education and safe sleep behaviors in the home using a cross-sectional survey of new parents at hospital discharge (HD) and 4-month follow-up (F/U). Knowledge and practices of infant safe sleep were compared to the National Infant Sleep Position Study benchmark. There were 1092 HD and 490 F/U surveys.

Advocacy and child neglect.

Pediatricians have a unique opportunity to intervene in the lives of children to identify and to prevent neglect. While it remains important to care for individual patients affected by neglect, the ecological model of child neglect requires intervention at the parent, family, community, and societal levels. Pediatricians can improve the outcomes for children by advocating for policies and interventions at each level.

Variability of the institutional review board process within a national research network.

Objective: To determine the variability of the institutional review board (IRB) process for a minimal risk multicenter study.

Methods: Participants included 24 Continuity Research Network (CORNET) sites of the Academic Pediatric Association that participated in a cross-sectional study. Each site obtained individual institutional IRB approval.

Decreasing unnecessary utilization in acute bronchiolitis care: results from the value in inpatient pediatrics network.

Background: Acute viral bronchiolitis is the most common diagnosis resulting in hospital admission in pediatrics. Utilization of non-evidence-based therapies and testing remains common despite a large volume of evidence to guide quality improvement efforts.

Objective: Our objective was to reduce utilization of unnecessary therapies in the inpatient care of bronchiolitis across a diverse network of clinical sites.

Effect of focused debriefing on team communication skills.

Background And Objective: Community hospitals often lack tertiary care support such as pediatric intensivists and anesthesiologists. Resuscitation of critically ill and injured children in community hospitals requires a well-coordinated team effort, because good team performance improves quality of care. The lack of subspecialty support makes team coordination and communication more imperative yet much more challenging.

Newborn adiposity by body mass index predicts childhood overweight.

Objective: To evaluate the association between adiposity at birth and in infancy with overweight at age 5 years. This study hypothesizes that adiposity at birth as approximated by body mass index (BMI) predicts childhood fatness.

Methods: Anthropomorphic data from birth to 5 years were used to calculate BMI percentiles.

Gender disparity in women's health training at a family medicine residency program.

Background And Objectives: Women's health services are an important part of the practice of family medicine. Anecdotally, family medicine residents' training experience in certain aspects of women's health differs based on the trainees' gender.

Methods: We conducted 5-year retrospective evaluation of acute and preventive women's health encounters at one site.