Electronic Discharge Summaries: Perspectives on National Implementation from Clinicians in Hospital and Primary Care.

This paper describes clinicians' views on the structure and content of an electronic discharge summary (EDS). A sample EDS template was developed by building on existing Australian guidelines to illustrate some of the proposed elements required for a high-quality clinical document. Surveys were widely disseminated to gather feedback and perspectives of hospital and primary care clinicians.

The development of National Safety and Quality Digital Mental Health Standards.

Objective: Digital mental health services offer innovative ways for individuals to access services but are not without risk. Our objective was to develop National Safety and Quality Digital Mental Health (NSQDMH) Standards that improve the quality of digital mental health service provision and protect service users from harm.

Method: The NSQDMH Standards were developed by adapting the National Safety and Quality Health Service (NSQHS) Standards and adding components highlighted through a national consultation process as critical to the safety and quality of services.

Characterization of four potential laser-induced fluorescence tracers for diesel engine applications.

Four potential laser-induced fluorescence (LIF) tracers, 1-phenyloctane, 1-phenyldecane, 1-methylnaphthalene, and 2-methylnaphthalene, are characterized for diesel engine applications. These tracers, embedded in the diesel primary reference fuels n-C₁₆H₃₄ and iso-C₁₆H₃₄, match the relevant physical properties of commercial diesel fuel much better than the commonly used toluene/iso-octane/n-heptane tracer-fuel system does. The temperature and pressure dependencies of the fluorescence intensities and spectra were measured in a flow cell in nitrogen for each candidate tracer molecule.

Physician professionalism and accountability: the role of collaborative improvement networks.

The medical profession is facing an imperative to deliver more patient-centered care, improve quality, and reduce unnecessary costs and waste. With significant unexplained variation in resource use and outcomes, even physicians and health care organizations with "the best" reputations cannot assume they always deliver the best care possible. Going forward, physicians will need to demonstrate professionalism and accountability in a different way: to their peers, to society in general, and to individual patients.

Atmospheric pressure acetylene detection by UV photo-fragmentation and induced C2 emission.

Detection of C(2)H(2) via UV photo-fragmentation, followed by monitoring the C(2) d(3)Π(g)-a(3)Π(u) fluorescence, is explored at atmospheric pressure and at temperatures of 295 K, 600 K, and 800 K, for excitation wavelengths 210 to 240 nm using a broadband laser source (~3 cm(-1) fwhm). At the lower temperature, C(2) emissions correlate closely with C(2)H(2) Ã ← X absorption bands, and the excitation spectra suggest a higher-transition probability for the v(″)(4) = 2 and 3 states than for the v(″)(4) = 0 and 1 states. As temperature increases, the excitation spectra exhibit a higher nonresonant background.

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.

LRO-LAMP observations of the LCROSS impact plume.

On 9 October 2009, the Lunar Crater Observation and Sensing Satellite (LCROSS) sent a kinetic impactor to strike Cabeus crater, on a mission to search for water ice and other volatiles expected to be trapped in lunar polar soils. The Lyman Alpha Mapping Project (LAMP) ultraviolet spectrograph onboard the Lunar Reconnaissance Orbiter (LRO) observed the plume generated by the LCROSS impact as far-ultraviolet emissions from the fluorescence of sunlight by molecular hydrogen and carbon monoxide, plus resonantly scattered sunlight from atomic mercury, with contributions from calcium and magnesium. The observed light curve is well simulated by the expansion of a vapor cloud at a temperature of ~1000 kelvin, containing ~570 kilograms (kg) of carbon monoxide, ~140 kg of molecular hydrogen, ~160 kg of calcium, ~120 kg of mercury, and ~40 kg of magnesium.

Designing a large-scale multilevel improvement initiative: the improving performance in practice program.

Improving Performance in Practice (IPIP) is a large system intervention designed to align efforts and motivate the creation of a tiered system of improvement at the national, state, practice, and patient levels, assisting primary-care physicians and their practice teams to assess and measurably improve the quality of care for chronic illness and preventive services using a common approach across specialties. The long-term goal of IPIP is to create an ongoing, sustained system across multiple levels of the health care system to accelerate improvement. IPIP core program components include alignment of leadership and leadership accountability, promotion of partnerships to promote health care quality, development of attractive incentives and motivators, regular measurement and transparent sharing of performance data, participation in organized quality improvement efforts using a standardized model, development of enduring collaborative improvement networks, and practice-level support.

Management patterns of childhood-onset nephrotic syndrome.

As an initial effort to identify opportunities to improve the management of children with nephrotic syndrome, the goal of this study was to assess the present-day management of children with primary nephrotic syndrome. A web-based survey was designed to assess the current management styles of all pediatric nephrology faculties at ten participating institutions. Ninety-one percent completed the initial survey.

Maintenance of Certification: the role of the American Board of Pediatrics in improving children's health care.

This article describes the evolution of board certification for pediatricians and the current ongoing assessment process called Maintenance of Certification (MOC). To be called a board-certified pediatrician under the MOC framework requires a level of training, competence, and knowledge that can only be achieved by completing a rigorous, defined, closely monitored training program approved by the Accreditation Council for Graduate Medical Education and then demonstrating a level of knowledge comparable to established standards by passing the initial certifying examination. Once this landmark baseline threshold is reached, the emphasis shifts to demonstrating lifelong professional development and the ability to deliver quality care and to continually improving that care through MOC.

Management of childhood onset nephrotic syndrome.

The therapeutic approach to childhood nephrotic syndrome is based on a series of studies that began with an international collaborative effort sponsored by the International Study of Kidney Disease in Children in 1967. The characteristics of children presenting with nephrotic syndrome have changed over recent decades with greater frequency of the challenging condition focal segmental glomerulosclerosis and a greater prevalence of obesity and diabetes mellitus, which may be resistant to glucocorticoids in the former and exacerbated by long-term glucocorticoid therapy in the latter 2 conditions. The Children's Nephrotic Syndrome Consensus Conference was formed to systematically review the published literature and generate a children's primary nephrotic syndrome guideline for use in educational, therapeutic, and research venues.

A continuum of competency assessment: the potential for reciprocal use of the Accreditation Council for Graduate Medical Education toolbox and the components of the American Board of Pediatrics Maintenance-of-Certification Program.

Reduction of unexplained variation in medical practice and health outcomes is of paramount importance, which indicates a need for a continuum of medical learning that begins in medical school and continues until the end of a professional career. That, in turn, indicates need for continuing assessment of professional competence. The American Board of Pediatrics, the American Academy of Pediatrics, and the Accreditation Council for Graduate Medical Education are working together to develop a common approach to documenting acquisition of competence during residency and maintenance of competence thereafter.

Alliance for pediatric quality: creating a community of practice to improve health care for America's children.

On any given day, hundreds of physicians, nurses, informaticists, health information management directors, and other health care providers are collaborating on how to improve health information technology systems for use in child health care. Many work in small communities of practice to share ideas, to find solutions, and to build innovations that support the goal of making electronic health record systems accessible by 2014. Together, they are a formidable virtual community aligned around a common strategy, to ensure that health information technology works for children.

Health information systems and physician quality: role of the American board of pediatrics maintenance of certification in improving children's health care.

A second revolution in quality is occurring in US health care, as profound as the Flexner revolution almost 100 years ago. Systems issues are the basis for most of the concern, but physician quality and professional development are also important. Specialty board certification and maintenance of certification are key drivers of professional development and improvement of care.

Pediatric recertification and quality of care: the role of the American Board of Pediatrics in improving children's health care.

American health care is in the middle of a second revolution in quality as profound as the Flexner revolution occurring almost 100 years ago. Although systems issues are the basis for most of the concern, physician quality and professional development are also pertinent. Specialty board certification and maintenance of certification are key drivers of professional development and improvement of care.