A safety culture transformation: its effects at a children's hospital.

Objective: To improve pediatric patient safety at a tertiary, 200-bed children's hospital by changing the safety culture and implementing processes, practices, and measures to sustain improvements. Although many core quality and safety measures exist for adult acute-care facilities, equivalent measures for pediatrics are lacking.

Methods: Helen DeVos Children's Hospital in Grand Rapids, Michigan, part of the Spectrum Health system, led a 2-year initiative beginning in late 2007 to improve pediatric patient safety.

Therapy of parapneumonic effusions in children: video-assisted thoracoscopic surgery versus conventional thoracostomy drainage.

Objective: Controversy surrounds the optimal treatment of parapneumonic effusions. This trial of pediatric patients with community-acquired pneumonia and associated parapneumonic processes compared primary video-assisted thoracoscopic surgery with conventional thoracostomy drainage.

Design: A prospective, randomized trial was conducted at DeVos Children's Hospital (Grand Rapids, MI) between November 2003 and May 2005.

Clinical efficacy of serial computed tomographic scanning in pediatric severe traumatic brain injury.

The purpose of this study is to determine whether serial computed tomography (CT) scans of the head lead to operative intervention in pediatric patients with severe traumatic brain injury (TBI). Serial CT scans are those done in addition to the initial CT scan and one follow up CT scan in the first 24-48 h. This study is a retrospective review from January 1990 to December 2003.

Snowmobile injuries and fatalities in children.

Background/purpose: Snowmobiling is a popular form of wintertime recreation but can be associated with significant morbidity and mortality. To better understand snowmobile trauma in children, medical records were reviewed, evaluating the relationships between demographic data, mechanisms, and resultant injuries. In addition, because prior studies of childhood snowmobile fatalities have reviewed only national databases, state and national data were combined to evaluate possible underreporting.