Quality care for children: inpatient medication use in a mid-Atlantic hospital system 2000-2003.

The authors report on a preliminary analysis of an electronic database that includes more than 32 000 pediatric hospitalizations during 2000-2003. They analyzed pediatric inpatient medication use in a defined geographic area, the catchment area for the Alfred I. duPont Hospital for Children, serving Delaware, Maryland, New Jersey, and Pennsylvania.

Closing the gap in children's quality measures: a collaborative model.

The need for measures of the quality of healthcare provided to children and adolescents is well documented. However, children have been underrepresented in national healthcare quality measurement and reporting efforts. The Pediatric Data Quality Systems (Pedi-QS) Collaborative is addressing this gap.

Improving physician communication through an automated, integrated sign-out system.

Communication failures among physicians are a leading cause of medical errors. The resident sign-out sheet is the primary tool used by house staff to facilitate the sign-out process. The resident sign-out sheet is a structured report, with patient-specific information including demographics, such a patient's name, age, sex, room number, and attending physician; problem list; medications; and allergies.

A simplified analysis to determine the impact of surgical procedure time on pediatric anesthesia productivity.

With fee-for-service (FFS) reimbursement, anesthesiologists benefit financially from cases that take longer than expected. Capitation, or fixed anesthesia reimbursement (FAR), might result in financial losses for such inefficient cases. In this investigation, we used the Centers for Medicare and Medicaid Services' average anesthesia times as benchmarks for efficiency and examined case time characteristics for three surgical services: otorhinolaryngology, general surgery, and orthopedics.

A model of determining a fair market value for teaching residents: who profits?

Context: Centers for Medicare & Medicaid Services (CMS) Health Resources and Services Administration Children's Hospitals Graduate Medical Education (GME) Payment Program now supports freestanding children's teaching hospitals.

Objective: To analyze the fair market value impact of GME payment on resident teaching efforts in our pediatric intensive care unit (PICU).

Design: Cost-accounting model, developed from a 1-year retrospective, descriptive, single-institution, longitudinal study, applied to physician teachers, residents, and CMS.

Intraoperative ultrasound reduces ECMO catheter malposition requiring surgical correction.

Background/purpose: One hundred ninety-three cannulation procedures for extracorporeal membrane oxygenation (ECMO) have been performed at the authors' institution from 1994 to now. Before 1996, their practice had been to position these catheters exclusively by clinical assessment and chest radiograph. Since then, the authors have utilized intraoperative ultrasound guidance during cannulation procedures to confirm proper tip position.