Daraiseh, N; Summerville, L; Lin, L; Tucker, D; Hill, A; Salisbury, K; Lind, M. Selection of employee personal protective equipment based on aggressive behavior in pediatric neuropsychiatry. Developmental Neurorehabilitation. 2018; 21(1):32-39.
Hospitalized patients with a developmental or intellectual disability and a psychiatric disorder (dual-diagnosis) often pose a risk to themselves or others leading to high injury rates for their providers. To reduce injuries resulting from interactions with dual-diagnosis patients, the initial behavioural assessment (IBA) and protective equipment decision key (PEDK) used in inpatient neuropsychiatry. The IBA-PEDK identify patients’ aggressive behaviors to provide employees with personal protective equipment (PPE). Researchers examined inter-rater reliability, validity, and adherence. Injuries significantly decreased after implementing the IBA-PEDK. A quick, user-friendly tool that provides a standardized method for determining PPE based on patient-specific behavior can significantly reduce aggression-related injuries.
Hartley, D; Giannini, C; Wilson, S; Frieder, O; Margolis, P; Kotagal, U; White, D; Connelly, B; Wheeler, D; Tadesse, D; Macaluso, M. Coughing, sneezing, and aching online: Twitter and the volume of influenza-like illness in a pediatric hospital. PloS one. 2017; 12(7):e0182008-e0182008.
In the 2014-2015 cold and flu season, the incidence of local tweets containing the terms flu, coughing, and headache were early indicators of the incidence of flu-related cases presenting to emergency departments and urgent care centers at our children's hospital. In the future, the use of twitter and other social media may predict fluctuations in volume.
Lail, J; Fields, E; Schoettker, P. Quality Improvement Strategies for Population Management of Children With Medical Complexity. Pediatrics. 2017; 140(3):e20170484-e20170484.
Children with medical complexity require the expertise of specialists and hospitals, but may lack primary care to provide preventive, acute, and chronic care management. We used quality improvement methodology to identify patients with the highest needs, reliably deliver appropriate preventive and chronic care, and implement pre-visit planning.
Walsh, M; Crowley, M; Wexelblatt, S; Ford, S; Kuhnell, P; Kaplan, H; McClead, R; Macaluso, M; Lannon, C; Collabora, O. Ohio Perinatal Quality Collaborative Improves Care of Neonatal Narcotic Abstinence Syndrome. Pediatrics. 2018; 141(4).
The incidence of neonatal abstinence syndrome after an infant’s in-utero exposure to opioids has increased dramatically. No treatment standards exist, leading to substantial variations in practice, degree of opioid exposure, and hospital length of stay. Standardized approaches to the identification and nonpharmacologic and pharmacologic care associates with a reduced length of opioid exposure (from 13.4 to 12.0 days) and hospital stay (from 18.3 to 17 days) in a large statewide collaborative. Other states and institutions treating opioid-exposed infants may benefit from the adoption of these practices.
Seid, M; Dellal, G; Peterson, L; Provost, L; Gloor, P; Fore, D; Margolis, P. Co-Designing a Collaborative Chronic Care Network (C3N) for Inflammatory Bowel Disease: Development of Methods. JMIR Human Factors. 2018; 5(1):e8-e8.
Our health care system fails to deliver necessary results, and incremental system improvements will not deliver needed change. Even though seen as a means to accelerate outcomes, improve care delivery, and further clinical research, few learning heal systems (LHSs) exist. We describe the process of codesigning, with all relevant stakeholders, an approach for creating a collaborative chronic care network (C3N), a peer-produced networked LHS.