The Rounds Efficiency Index: A Novel Physics-Based Construct for Patient- and Family-Centered Rounds.

Background And Objectives: Efficiently conducting patient- and family-centered rounds (PFCR) is challenging, particularly without a measure of efficiency. In physics, efficiency is the ratio of work output to work input. We sought to evaluate PFCR efficiency via a novel construct rooted in physics.

Using Electronic Health Record Modifications to Increase Use of Adolescent Sensitive Notes.

Objectives: Confidentiality is imperative when caring for adolescents, yet the 21st Century Cures Act ensures guardian access to some of their child's documentation. Pediatric Hospital Medicine (PHM) history and physical (H&P) notes are visible to guardians, whereas adolescent sensitive notes (ASN) are not. Our aim was to decrease sexual history and substance use (SHSU) documentation in H&P notes.

Use of Peer- and Self-Evaluation to Improve Conversations with Interfacility Referring Clinicians.

Introduction: Pediatric hospital medicine physicians receive little formal training in communicating with interfacility referring clinicians. We sought to improve pediatric hospital medicine physician confidence and communication scores by 10% during patient triage calls from interfacility referring providers via a continuing professional development initiative.

Methods: We conducted a single-center 10-month quality improvement project.

Overweight Infants Hospitalized for Bronchiolitis Associated With Severe Disease.

Objectives: Overweight negatively affects pediatric respiratory function. In this study, we evaluate if overweight is associated with more severe bronchiolitis in hospitalized infants.

Methods: This retrospective cohort study analyzed infants aged 30 to 365 days hospitalized for bronchiolitis from September 2019 to April 2020.

Improving Documentation of Postdischarge Issue Mitigation during Postdischarge Phone Calls.

Unlabelled: Postdischarge phone calls (PDPCs) are recommended to identify and mitigate postdischarge issues such as missed follow-up appointments, medication errors, and failure to activate contingency plans. A current state assessment showed variability in documenting PDPC content and postdischarge issue mitigation. Therefore, the primary aim was to improve the postdischarge issue mitigation documentation rate from 65% to 100% over 16 months.

Pediatric Respiratory Illness Hospitalizations Prior to COVID-19 and During the First Year of the COVID-19 Pandemic in Southeast Wisconsin.

Background: Public health measures combatting the COVID-19 pandemic also led to a decrease in other pediatric respiratory illnesses. We describe the local pattern of pediatric respiratory hospitalizations in southeast Wisconsin prior to COVID-19 and during the first year of the pandemic.

Methods: We performed a cross-sectional examination of hospitalizations for asthma, bronchiolitis, and bacterial pneumonia at a single tertiary children's hospital prior to COVID-19 through the first year of the COVID-19 pandemic.

An Opportunity in Cancer Prevention: Human Papillomavirus Vaccine Delivery in the Hospital.

Objective: Pediatric hospitalizations are a missed opportunity for delivery of the human papilloma virus (HPV) vaccination. In this study, the authors' aim was to increase HPV vaccination rates among adolescents cared for by the pediatric hospital medicine (PHM) service at our academic children's hospital.

Methods: This quality improvement (QI) study included adolescents ≥13 years who were discharged from PHM.

Quality Initiative to Increase Delivery of Adolescent Hospital-Based Reproductive Health Care.

Objectives: Hospitals are an important nontraditional setting in which to address adolescent reproductive health. However, opportunities for intervention are frequently missed, especially for boys and patients hospitalized for noningestion complaints. Our global aim was to increase delivery of reproductive health care to adolescents hospitalized through our children's hospital Pediatric Hospital Medicine service.

Using Electronic Health Record Tools to Decrease Antibiotic Exposure in Infant Sepsis Evaluation.

Background: Our internal infant sepsis evaluation clinical practice guideline recommends infants with negative culture results who are undergoing sepsis evaluation receive antibiotics until culture results are negative for a maximum of 36 hours. The aims of our project were to decrease the percentage of patients who received >30 hours of administered antibiotic doses (recognizing effective concentrations last until hour 36) and increase 36-hour phrase documentation by using clinical decision support tools.

Methods: We used quality improvement methodology to study infants aged ≤60 days with negative culture results.

Pediatric COVID-19 Delirium: Case Report of 2 Adolescents.

Introduction: Neurological complications of COVID-19, including delirium, are emerging in the adult population but have not been well described in pediatrics.

Case Presentation: We report the cases of 2 adolescent males, ages 16 and 17, who presented with delirium secondary to an acute COVID-19 infection in the fall of 2020 at Children's Wisconsin in Milwaukee, Wisconsin. The foundation of our treatment strategy was the triad of alpha-2 agonists (clonidine, dexmedetomidine, guanfacine), antipsychotic agents (quetiapine, haloperidol, olanzapine), and melatonin.

One Call Away: Addressing a Safety Gap for Urgent Issues Post Discharge.

Objectives: The transition period from hospitalization to outpatient care can be high risk for pediatric patients. Our aim was to profile the use of a "safety net" for families through provision of specific inpatient provider contact information for urgent issues post discharge.

Methods: In this prospective study, we implemented an updated after-visit summary that directed families to call the hospital operator and specifically ask for the pediatric hospital medicine attending on call if they were unable to reach their primary care provider (PCP) with an urgent postdischarge concern.

Letting Residents Lead: Implementing Resident Admission Triage Call Curriculum and Practice.

Background And Objectives: Graduating residents are expected to be competent in triaging patients to appropriate resources. Before 2017, pediatric residents were not involved in admission triage decisions. In 2017, after implementing an admission triage curriculum (ATC), residents had opportunities to be involved in overnight admission calls with the emergency department (ED), which were initially supervised (joint calls), and as skills progressed, residents conducted calls and admitted patients independently.

Identifying characteristics and outcomes in youth with obesity and developmental disabilities.

Background: Youth with developmental disability are at increased risk of obesity; literature focusing on the two is rare.

Objective: To identify characteristics and outcomes of youth presenting for obesity care having a disability as compared to without.

Methods: A medical record review of youth aged 2-18 years initiating obesity care 2013-2015 at a tertiary care obesity management program.

Primary Care-Based Interventions to Promote Positive Parenting Behaviors: A Meta-analysis.

Context: Utilization of primary care settings offers a promising approach to enhance parenting practices that are critical for promoting early childhood development. Determining the impact of existing primary care interventions on key parenting behaviors will aid providers and policy makers as they seek strategies to improve early child outcomes.

Objective: To evaluate the efficacy of primary care-based interventions on parenting practices that promote early child development among children younger than 36 months.

Primary Immune Deficiency Treatment Consortium (PIDTC) report.

The Primary Immune Deficiency Treatment Consortium (PIDTC) is a network of 33 centers in North America that study the treatment of rare and severe primary immunodeficiency diseases. Current protocols address the natural history of patients treated for severe combined immunodeficiency (SCID), Wiskott-Aldrich syndrome, and chronic granulomatous disease through retrospective, prospective, and cross-sectional studies. The PIDTC additionally seeks to encourage training of junior investigators, establish partnerships with European and other International colleagues, work with patient advocacy groups to promote community awareness, and conduct pilot demonstration projects.

The YaaA protein of the Escherichia coli OxyR regulon lessens hydrogen peroxide toxicity by diminishing the amount of intracellular unincorporated iron.

Hydrogen peroxide (H(2)O(2)) is commonly formed in microbial habitats by either chemical oxidation processes or host defense responses. H(2)O(2) can penetrate membranes and damage key intracellular biomolecules, including DNA and iron-dependent enzymes. Bacteria defend themselves against this H(2)O(2) by inducing a regulon that engages multiple defensive strategies.

Genetic testing for autism spectrum disorders.

Children with autism spectrum disorders (ASD) have unique developmental and behavioral phenotypes, and they have specific challenges with communication, social skills, and repetitive behaviors. At this time, no single etiology for ASD has been identified. However, evidence from family studies and linkage analyses suggests that genetic factors play a pivotal role in the etiology of ASD.

Kindergarten readiness after prematurity: Integrating health, development, and behavioral functioning to optimize educational outcomes of vulnerable children.

In the past 20 years, many advances (e.g., maternal steroids and surfactant) have changed the course of neonatal medicine.