Using the Electronic Health Record to Implement Expedited Partner Therapy in the Pediatric Emergency Department.

Objectives: Expedited partner therapy (EPT) is a partner treatment strategy for sexually transmitted infections (STIs) including gonorrhea and chlamydia as well as trichomoniasis in some states. The process allows healthcare providers to write prescriptions for STI treatment among partners of infected patients without a previous medical evaluation. The Centers for Disease Control (CDC) has recommended EPT as a useful option to facilitate partner treatment, particularly male partners of women with chlamydia or gonorrhea infections.

A Pilot Study of a Measure of Parental Trust in Pediatric Emergency Department Care Teams.

Objective: To modify and test an existing measure of trust validated in a primary care setting for use in a pediatric emergency department (PED).

Methods: The study population was parents/guardians who brought their child to an urban PED with a chief complaint of abdominal pain or head injury. We used a 2-phase design with modifications resulting from cognitive interviews with 15 participants followed by a field test with 150 participants.

Leveraging a Public Health Framework and Community Advisory Board to Innovate Workplace Violence Intervention Strategies.

Even with extensive evidence documenting the incidence, risk factors, and negative outcomes of workplace violence (WPV) against emergency department (ED) employees, there is a lack of intervention strategies reported that could be subjected to a clinical trial in the ED setting. The purpose of this article is to report the outcomes of a novel process adapted from the Framework for Program Evaluation in Public Health for soliciting intervention strategies from a WPV Community Advisory Board (CAB) organized by the U.S.

A Real-Time Automated Patient Screening System for Clinical Trials Eligibility in an Emergency Department: Design and Evaluation.

Background: One critical hurdle for clinical trial recruitment is the lack of an efficient method for identifying subjects who meet the eligibility criteria. Given the large volume of data documented in electronic health records (EHRs), it is labor-intensive for the staff to screen relevant information, particularly within the time frame needed. To facilitate subject identification, we developed a natural language processing (NLP) and machine learning-based system, Automated Clinical Trial Eligibility Screener (ACTES), which analyzes structured data and unstructured narratives automatically to determine patients' suitability for clinical trial enrollment.

A Time-and-Motion Study of Clinical Trial Eligibility Screening in a Pediatric Emergency Department.

Objective: Challenges with efficient patient recruitment including sociotechnical barriers for clinical trials are major barriers to the timely and efficacious conduct of translational studies. We conducted a time-and-motion study to investigate the workflow of clinical trial enrollment in a pediatric emergency department.

Methods: We observed clinical research coordinators during 3 clinically staffed shifts.

Factors influencing ED care of young children at-risk for clinically important traumatic brain injury.

Objectives: Care decisions for young children presenting to the emergency department (ED) with head injury are often challenging (e.g. whether to obtain neuroimaging).

Suboptimal Clinical Documentation in Young Children with Severe Obesity at Tertiary Care Centers.

The prevalence of severe obesity in children has doubled in the past decade. The objective of this study is to identify the clinical documentation of obesity in young children with a BMI ≥ 99th percentile at two large tertiary care pediatric hospitals. We used a standardized algorithm utilizing data from electronic health records to identify children with severe early onset obesity (BMI ≥ 99th percentile at age <6 years).

Developing an Algorithm to Detect Early Childhood Obesity in Two Tertiary Pediatric Medical Centers.

Objective: The objective of this study is to develop an algorithm to accurately identify children with severe early onset childhood obesity (ages 1-5.99 years) using structured and unstructured data from the electronic health record (EHR).

Introduction: Childhood obesity increases risk factors for cardiovascular morbidity and vascular disease.

Family-Centered Pediatric Emergency Care: A Framework for Measuring What Parents Want and Value.

Objective: To identify and describe dimensions of family-centered care important to parents in pediatric emergency care and compare them to those currently defined in the literature.

Methods: A qualitative study was conducted involving 8 focus groups with parents who accompanied their child to an emergency department visit at a large tertiary-care pediatric health system. Participants were identified using purposive sampling to achieve representation across demographic characteristics including child's race, insurance status, severity, and participant's relationship to child.

Sustained reductions in time to antibiotic delivery in febrile immunocompromised children: results of a quality improvement collaborative.

Background: Timely delivery of antibiotics to febrile immunocompromised (F&I) paediatric patients in the emergency department (ED) and outpatient clinic reduces morbidity and mortality.

Objective: The aim of this quality improvement initiative was to increase the percentage of F&I patients who received antibiotics within goal in the clinic and ED from 25% to 90%.

Methods: Using the Model of Improvement, we performed Plan-Do-Study-Act cycles to design, test and implement high-reliability interventions to decrease time to antibiotics.

Preparing for International Classification of Diseases, 10th Revision, Clinical Modification implementation: strategies for maintaining an efficient workflow.

The International Classification of Diseases, 10th Revision, is required to be used by the Centers for Medicare and Medicaid Services health care billing data starting in October 2015 in the United States. The International Classification of Diseases, 10th Revision, is an update to the International Classification of Diseases, Ninth Revision, and contains approximately 70,000 codes compared with 14,000 codes. We aimed to discuss how our institution is updating the coding system in a manner that alleviates the possible burden placed on providers including more coding information required and longer load times.

Automated clinical trial eligibility prescreening: increasing the efficiency of patient identification for clinical trials in the emergency department.

Objectives: (1) To develop an automated eligibility screening (ES) approach for clinical trials in an urban tertiary care pediatric emergency department (ED); (2) to assess the effectiveness of natural language processing (NLP), information extraction (IE), and machine learning (ML) techniques on real-world clinical data and trials.

Data And Methods: We collected eligibility criteria for 13 randomly selected, disease-specific clinical trials actively enrolling patients between January 1, 2010 and August 31, 2012. In parallel, we retrospectively selected data fields including demographics, laboratory data, and clinical notes from the electronic health record (EHR) to represent profiles of all 202795 patients visiting the ED during the same period.

EMR-linked GWAS study: investigation of variation landscape of loci for body mass index in children.

Unlabelled: Common variations at the loci harboring the fat mass and obesity gene (FTO), MC4R, and TMEM18 are consistently reported as being associated with obesity and body mass index (BMI) especially in adult population. In order to confirm this effect in pediatric population five European ancestry cohorts from pediatric eMERGE-II network (CCHMC-BCH) were evaluated.

Method: Data on 5049 samples of European ancestry were obtained from the Electronic Medical Records (EMRs) of two large academic centers in five different genotyped cohorts.

Hair tourniquet of the circumvallate papillae: a potentially "hairy" situation.

Oral foreign bodies and hair-thread tourniquets are fairly common findings. The combination of the two, however, is rarer. In this article, we present a case involving a hair-thread tourniquet of a circumvallate papillae (more commonly known as a "taste bud").

Modifications and integration of the electronic tracking board in a pediatric emergency department.

Electronic health records (EHRs) are used for data storage; provider, laboratory, and patient communication; clinical decision support; procedure and medication orders; and decision support alerts. Clinical decision support is part of any EHR and is designed to help providers make better decisions. The emergency department (ED) poses a unique environment to the use of EHRs and clinical decision support.

A comprehensive view of parental satisfaction with pediatric emergency department visits.

Study Objective: We develop a comprehensive view of aspects of care associated with parental satisfaction with pediatric emergency department (ED) visits, using both quantitative and qualitative data.

Methods: This was a retrospective observational study using data from an institution-wide system to measure patient satisfaction. For this study, 2,442 parents who brought their child to the ED were interviewed with telephone survey methods.

The association of emergency department crowding and time to antibiotics in febrile neonates.

Objectives: The objective was to assess the relationship between emergency department (ED) crowding and timeliness of antibiotic administration to neonates presenting with fever in a pediatric ED.

Methods: This was a retrospective cohort study of febrile neonates (aged 0-30 days) evaluated for serious bacterial infections (SBIs) in a pediatric ED from January 2006 to January 2008. General linear models were used to evaluate the association of five measures of ED crowding with timeliness of antibiotic administration, controlling for patient characteristics.

Use of a discharge facilitator improves recall of emergency department discharge instructions for acute gastroenteritis.

Objective: To determine whether the use of a bilingual discharge facilitator (DF) improves parental recall of discharge instructions in acute gastroenteritis in a pediatric emergency department (ED).

Methods: A nonrandomized educational intervention study with a historical control was conducted in a tertiary children's hospital between January 2004 and November 2004. English- or Spanish-speaking parents of patients aged 3 months to 18 years with conditions diagnosed as acute gastroenteritis were eligible.

Impact of disaster drills on patient flow in a pediatric emergency department.

Objectives: Joint Commission on Accreditation of Healthcare Organizations (JCAHO)-accredited hospitals must conduct disaster drills twice a year, with one incorporating a mass casualty incident to the emergency department (ED). The authors found no studies describing the potential negative impact on the quality of care real patients in the ED receive during these drills. The objective was to determine the impact that mass casualty drills have on the timeliness of care for nondisaster patients in a pediatric ED.