Investing in a New Role to Increase Timely Morning Discharges in the Inpatient Setting.

Objective: Delays in discharges have a downstream effect on emergency department admissions, wait times, intensive care unit transfers, and elective admissions. This quality improvement project's aim was to increase the percentage of discharges before noon from a hospital medicine service from 19% to 30% over a 6-month period and sustain the increase for 6 months.

Methods: Interventions included introduction of a dedicated patient flow provider (PFP), optimization of workflow, technology assistance with discharge tasks, and multidisciplinary education on patient flow.

Impact of the SARS-CoV-2 pandemic on the health of individuals with intoxication-type metabolic diseases-Data from the E-IMD consortium.

The SARS-CoV-2 pandemic challenges healthcare systems worldwide. Within inherited metabolic disorders (IMDs) the vulnerable subgroup of intoxication-type IMDs such as organic acidurias (OA) and urea cycle disorders (UCD) show risk for infection-induced morbidity and mortality. This study (observation period February 2020 to December 2021) evaluates impact on medical health care as well as disease course and outcome of SARS-CoV-2 infections in patients with intoxication-type IMDs managed by participants of the European Registry and Network for intoxication type metabolic diseases Consortium (E-IMD).

Vagus nerve stimulation in pediatric patients with failed epilepsy surgery.

Adequate control of pharmacoresistant epilepsy continues to be a challenge. Multiple studies have reported the benefits of epilepsy surgery and vagus nerve stimulation for children with pharmacoresistant epilepsy. Little is known about the role of vagus nerve stimulation for children with failed epilepsy surgeries.

Vagus nerve stimulation for 6- to 12-year-old children with refractory epilepsy: Impact on seizure frequency and parenting stress index.

Objectives: Refractory epilepsy (RE) is frequently associated with neuropsychological impairment in children and may disrupt their social development. Vagus nerve stimulation (VNS) had been reported to have beneficial effects on behavioral outcomes. The aim of this study was to compare Parenting Stress Index (PSI) scores before and after VNS device implantation in children with RE, especially those who experienced seizure frequency reduction.

Validity of Simulation-Based Assessment for Accreditation Council for Graduate Medical Education Milestone Achievement.

Introduction: The Accreditation Council for Graduate Medical Education requires biannual evaluation of anesthesiology residents on 25 subcompetency milestones. Some milestone domains are particularly challenging to repeatedly and reliably observe during clinical care. Simulation-Based Milestones Assessment (SBMA) may help overcome these challenges.

Multisite Emergency Department Inpatient Collaborative to Reduce Unnecessary Bronchiolitis Care.

Background And Objectives: There is high variation in the care of acute viral bronchiolitis. We sought to promote collaboration between emergency department (ED) and inpatient (IP) units with the goal of reducing unnecessary testing and treatment.

Methods: Multisite collaborative with improvement teams co-led by ED and IP physicians and a 1-year period of active participation.

Blueprint for Action: Visioning Summit on the Future of the Workforce in Pediatrics.

The Federation of Pediatric Organizations engaged members of the pediatric community in an 18-month process to envision the future of the workforce in pediatrics, culminating in a Visioning Summit on the Future of the Workforce in Pediatrics. This article documents the planning process and methods used. Four working groups were based on the 4 domains that are likely to affect the future workforce: Child Health Research and Training, Diversity and Inclusion, Gender and Generations, and Pediatric Training Along the Continuum.

Post-natal ultrasound morpho-dynamic evaluation of mild fetal hydronephrosis: a new management.

Background: Fetal hydronephrosis is the most common anomaly detected on antenatal ultrasound examination, affecting 1-5% pregnancies.

Aim: A new management in mild antenatal renal pelvis dilatation (ARPD), using a technique based on both morphological and dynamical evaluation.

Materials And Methods: Prospective study conducted during a 36-months period in 180 consecutive newborns referred as having mild ARPD.

Primary vertebral lymphoma presenting with fracture.

We report a 15 year old girl admitted with back pain and multifocal osteolytic lesions without systemic symptoms at T7, L5, and S1 spinal vertebras. The child was diagnosed as having primary multifocal osseous lymphoma, in which multiple bones are involved in the absence of lymph node or visceral disease for at least 6 months following initial presentation.