Background: Project IMPACT (Improving Pediatric Patient-Centered Care Transitions) is a multi-center quality improvement collaborative aiming to improve hospital to home transitions. As part of this project, providers attempt to schedule follow-up visits prior to discharge and conduct post-discharge phone calls. Objective: 1.Determine relationship between scheduling post-discharge follow-up visits and 30-day reutilization rates 2. Characterize patients [...]

Background: To address safety risks with transitions from hospital to home, the IMPACT collaborative designed, tested and implemented the Pediatric Patient Centered Care Transition (PACT) Bundle. The bundle element “perfect” handoff (timely and complete) aimed to improve hospitalist handoff to outpatient providers at hospital discharge.Our objective was to  assess outpatient medical provider’s perceptions of hospitalists’ handoff [...]

Background: Post discharge (d/c) follow-up calls are utilized for many reasons: monitoring patient (pt) status, understanding of d/c instructions including medications and appointments, and satisfaction with hospital care. Adult data suggests such calls improve satisfaction and may impact readmission rates. Little data about the impact of such calls on pediatrics pts exists. Our objective was [...]

Background: Pediatric (ped) short stay admissions of

Background:  Healthcare delivery has become more expensive, with a portion of the elevated cost due to increased utilization of laboratory studies. The Choosing Wisely campaign is an initiative of the American Board of Internal Medicine Foundation focused on preventing wasteful care. Accordingly, the Critical Care Societies Collaborative developed an evidence-based list describing overutilization practices.  This [...]

Background: Hospital discharges early in the day help facilitate patient throughput and improve capacity.  A key step in the discharge process is the entry of the physician discharge order.  The degree of variation in physician discharge order time has not been explored. Methods: We identified all patient discharges from two general pediatric services at a [...]

Background: While constipation is largely addressed in the outpatient setting, children are sometimes hospitalized for this issue.  The impact of hospitalization for constipation on subsequent constipation-related healthcare utilization is poorly understood. Methods: First admissions for constipation in 2010-2011 were identified in the Truven Marketscan Medicaid Database, which includes children enrolled in Medicaid in multiple de-identified states.  [...]

Background: Children with sleep apnea are at increased risk for adverse respiratory events following surgical procedures involving the airway such as tonsillectomy. Risk following sedation for non-invasive procedures is unclear. The objective of this study was to identify risk factors for overnight desaturation events (ODE) in patients with sleep apnea admitted after sedated magnetic resonance [...]

Background: Hospitalist-comanagement model in surgical patients has demonstrated good results in terms of length of hospital stay, readmissions, quality of care and costs in the American Medical System. However, results from international cohorts are very limited. The objective of our study is to assess the impact of hospitalist-comanagement with orthopedic surgeons for patients who underwent [...]

Background: The 2014 ACC/AHA Perioperative Guidelines suggest using the Revised Cardiac Risk Index (RCRI), myocardial infarction or cardiac arrest (MICA), or American College of Surgeons (ACS)-NSQIP calculators for combined patient-surgical risk assessment. However, there is no published data comparing their performance. Methods: We retrospectively reviewed records of 663 patients seen in our preop clinic who [...]