Implementation of a Children's Hospital Acute Care Behavior Response Team.

Background: Pediatric patients with behavioral needs are frequently admitted to the hospital for medical care; when behavioral crises occur, patients and staff are at risk for injury. Our aim was to implement a behavior response team (BRT) to increase the days between employee injury due to aggressive patient interactions on the inpatient medical units from 99 to 150 over 1 year.

Methods: A multidisciplinary team used quality improvement methods to design and implement the BRT system that includes 2 options: huddle to proactively plan for patients exhibiting early signs of escalation and STAT for immediate help for patients with imminent risk of harm to self or others.

Should Tactile Defensiveness Exclude a Life-Sustaining Intervention in an Adolescent With Autism?

This Ethics Rounds considers the benefits and burdens of a potentially temporary tracheostomy in an adolescent with autism and severe tactile defensiveness.

The Respiratory Therapy Practice-Based Outcomes Initiative (RT-PBOI): Developing a framework to explore the value added by respiratory therapists to health care in Alberta.

Background: There exists a political imperative to have access to data that meets the needs of health care administrators, governments, and funding bodies to support evidence-informed decision making. It is incumbent upon respiratory therapists to examine how they can deliver the highest-quality patient care, but also that they add value to health systems that ensure the benefits of health innovations are shared equitably among all members of our communities.

Purpose: To explore the perceived value contributed by the respiratory therapy profession to health care and the health care system in the Province of Alberta at patient, team, and system levels.

Clozapine for Drug-Refractory Irritability in Individuals with Developmental Disability.

Objectives: In this case series, we describe the acute clinical impact and tolerability of rapid titration of clozapine for treatment of refractory irritability in five hospitalized youth with developmental disability. We offer this descriptive report in an effort to expand the evidence base guiding treatment of refractory aggression in this population.

Methods: Five youth with developmental disability and severe irritability were admitted to a 10-bed psychiatric crisis stabilization unit where they received thorough psychiatric and medical evaluation.

Autism spectrum disorders.

Autism spectrum disorders are being diagnosed with increasing frequency. The likelihood that a primary care provider will see a patient with autism spectrum disorder in their clinic is high. In this article, current diagnostic criteria and expected changes in DSM criteria, as well as prevalence rates and epidemiologic studies are reviewed.