Chronic Graft-Versus-Host Disease Adversely Impacts School Performance in Children and Young Adults.

Background: Chronic graft-versus-host disease (cGVHD) adversely impacts return to work for adult allogeneic hematopoietic stem cell transplant (HSCT) survivors, but no data exist on children with cGVHD transitioning back to school. We hypothesized that cGVHD adversely impacts broad aspects of school experience of children compared to their allogeneic-HSCT peers without cGVHD.

Methods: We conducted a single center cross-sectional pilot study using a 42-item questionnaire, investigating academic performance and social-emotional aspects of schooling pre- and post-HSCT.

Improving Usability of the Pediatric Code Cart by Combining Lean and Human Factors Principles.

Unlabelled: Cardiac arrests are common in hospitalized children. Well-organized code carts are needed during these events to help staff efficiently find supplies and medications for the patient. This study aimed to improve the efficiency and utilization of the code cart at a major academic pediatric medical center.

Usability of human-computer interaction in neonatal care.

While a goal for Electronic Health Record (EHR) technologies was to improve quality, efficiency, and safety, the usability of EHRs has remained poor. The relation to patient harm and user satisfaction cannot be ignored. Optimization of EHR usability is imperative to improving the outcomes for critically ill patients, especially neonates who are at the extremes of physiologic variability.

Alert-Triggered Patient Education Versus Nurse Feedback for Nonadministered Venous Thromboembolism Prophylaxis Doses: A Cluster-Randomized Controlled Trial.

Background Many hospitalized patients are not administered prescribed doses of pharmacologic venous thromboembolism prophylaxis. Methods and Results In this cluster-randomized controlled trial, all adult non-intensive care units (10 medical, 6 surgical) in 1 academic hospital were randomized to either a real-time, electronic alert-triggered, patient-centered education bundle intervention or nurse feedback intervention to evaluate their effectiveness for reducing nonadministration of venous thromboembolism prophylaxis. Primary outcome was the proportion of nonadministered doses of prescribed pharmacologic prophylaxis.

Automated hand hygiene compliance system's audible alert reminder increases healthcare worker hand hygiene compliance.

Objective: To evaluate the effectiveness of an automated hand hygiene compliance system (AHHCS) audible alert and vibration for increasing hand hygiene compliance.

Design: A nonrandomized, before-and-after, quasi-experimental study of an AHHCS was implemented in several inpatient units. Over a 51-day period, the system's real-time audible alert was turned on, off, and back on.

Handoffs and Teamwork: A Framework for Care Transition Communication.

Background: Handoffs occur frequently in the medical domain and are associated with up to 80% of medical errors. Although research has progressed, handoffs largely remain inadequate. The absence of an appropriate conceptual model for handoffs hinders the purposeful design and evaluation of handoff procedures.

Examining Diurnal Differences in Multidisciplinary Care Teams at a Pediatric Trauma Center Using Electronic Health Record Data: Social Network Analysis.

Background: The care of pediatric trauma patients is delivered by multidisciplinary care teams with high fluidity that may vary in composition and organization depending on the time of day.

Objective: This study aims to identify and describe diurnal variations in multidisciplinary care teams taking care of pediatric trauma patients using social network analysis on electronic health record (EHR) data.

Methods: Metadata of clinical activities were extracted from the EHR and processed into an event log, which was divided into 6 different event logs based on shift (day or night) and location (emergency department, pediatric intensive care unit, and floor).

Application of Human Factors Methods to Ensure Appropriate Infant Identification and Abduction Prevention Within the Hospital Setting.

Infant misidentification and abduction are recognized as "never" events for hospitals in the United States. As near misses are often unreported, root cause analysis of observed near misses may fail to uncover important contributors. We utilized failure mode and effects analysis to proactively identify and eliminate or reduce the risk of infant misidentification or abduction.

Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: Is there a differential effect by race?

Background: Racial disparities are common in healthcare. Venous thromboembolism (VTE) is a leading cause of preventable harm, and disparities observed in prevention practices. We examined the impact of a patient-centered VTE education bundle on the non-administration of preventive prophylaxis by race.

Linking Electronic Health Record and Trauma Registry Data: Assessing the Value of Probabilistic Linkage.

Background: Electronic health record (EHR) systems contain large volumes of novel heterogeneous data that can be linked to trauma registry data to enable innovative research not possible with either data source alone.

Objective: This article describes an approach for linking electronically extracted EHR data to trauma registry data at the institutional level and assesses the value of probabilistic linkage.

Methods: Encounter data were independently obtained from the EHR data warehouse ( = 1,632) and the pediatric trauma registry ( = 1,829) at a Level I pediatric trauma center.

Characterizing the Utilization of the Problem List for Pediatric Trauma Care.

The EHR problem list has the potential to support care coordination among the multidisciplinary care team that cares for pediatric trauma patients. To realize this potential, the need exists to ensure appropriate utilization by formulating acceptable usage and management policy. In this regard, understanding the prevailing utilization pattern is pivotal.

Effect of Real-time Patient-Centered Education Bundle on Administration of Venous Thromboembolism Prevention in Hospitalized Patients.

Importance: Numerous interventions have improved prescription of venous thromboembolism (VTE) prophylaxis; however, many prescribed doses are not administered to hospitalized patients, primarily owing to patient refusal.

Objective: To evaluate a real-time, targeted, patient-centered education bundle intervention to reduce nonadministration of VTE prophylaxis.

Design, Setting, And Participants: This nonrandomized controlled, preintervention-postintervention comparison trial included 19 652 patient visits on 16 units at The Johns Hopkins Hospital, Baltimore, Maryland, from April 1 through December 31, 2015.

Dissecting Communication Barriers in Healthcare: A Path to Enhancing Communication Resiliency, Reliability, and Patient Safety.

Suboptimal exchange of information can have tragic consequences to patient's safety and survival. To this end, the Joint Commission lists communication error among the most common attributable causes of sentinel events. The risk management literature further supports this finding, ascribing communication error as a major factor (70%) in adverse events.

Framing Egg Donation: A Dichotomous Split.

Reproductive medicine has depended upon the altruistic motivations of women to donate eggs. Donors are lauded for these self-sacrificing actions but are treated as a product during the selection and donation process. This process highlights the contradictory behaviors as evidence to the dichotomous split of the definition of women as "virgins" or "whores," by attracting women to donate as the former and treating them as the latter.