Background: Asthma is the leading chronic disease in children with prevalence approaching 10%. Barriers to follow up care, poor access to medication and lack of disease education pose a threat to patient safety and increase the risk for hospital re-utilization. The Improving Pediatric Patient Centered Care Transitions (IMPACT) collaborative designed and implemented a 4- element [...]

Background: Over the course of several months, five adolescent patients were admitted to the hospital after intentional self-injurious behaviors involving foreign body ingestion. These patients were previously living in residential treatment centers, and via social media alerted each other of the benefits of being admitted to a children’s hospital including: private rooms/bathrooms, individualized attention, attendance [...]

Background: Patient- and family- centered care (PFCC) is a key element of safe healthcare. Family-centered-rounds (FCR) incorporate PFCC into the daily workflow of children’s hospitals. This observational study assessed whether our rounds on the Baystate Children’s Hospital Infant’s and Children’s unit met key goals of FCR including providing medical information, engaging in open, bidirectional communication, [...]

Background: Migraine headache (MHA) is a common pediatric illness with up to 75% of children experiencing an episode by the age of 15. Up to 58% of adult MHA patients have a psychiatric comorbidity (PC), but the percentage of children with MHA and PC is unknown. At Phoenix Children’s Hospital (PCH), migraine is one of [...]

Background: Migraine headache (MHA) is a common pediatric disorder, which frequently leads to hospital admission. Inpatient MHA treatment involves various medications, including a combination of fluids, antiemetics, non-steroidal anti-inflammatory drugs, steroids, and anti-convulsants. Severe or recalcitrant headache may require more aggressive therapies, including dihydroergotamine (DHE). Opiates are not recommended in the treatment of MHA; however [...]

Background: Neonatal abstinence syndrome (NAS) occurs when an infant is exposed to licit or illicit chemical substances in utero and manifests symptoms of withdrawal from the substance(s) after birth. NAS is a clinical diagnosis, but is generally confirmed with testing of infant urine and/or meconium to identify specific causative substances. Appropriate identification, documentation, and communication [...]

Background: In 2011, the Infectious Diseases Society of America (IDSA) published new guidelines on the management of community acquired pneumonia (CAP) in children and recommended use of narrow spectrum antibiotics such as ampicillin or amoxicillin over broader spectrum antibiotics such as ceftriaxone. Many studies have shown that these guidelines have been adopted with varying success [...]

Background: Adolescent reproductive health services are essential to prevent transmission of sexually transmitted infections (STIs) and teen pregnancy. Half of all new STIs occur among 15-24 year-olds and approximately 750,000 teenage females become pregnant per year. Adolescents have poor access to preventive care, and even when seen in the primary care setting, reproductive health is [...]

Background: One out of every 5 teens has had mental illness with severe impairment in their lifetime. Furthermore, from 2008-2015 the number of hospitalizations for suicidal ideation (SI)/suicide attempt (SA) more than tripled and the percentage of all hospitalizations doubled for SI/SA across 31 children’s hospitals. Given the increasing burden observed in the hospital setting, [...]

Background: Family Partners (FP) are peer mentors trained to support parents facing clinical situations similar to what FPs previously experienced with their own children. FPs offer a family-centered, cost-effective intervention that can improve outcomes, particularly for children with prematurity or chronic diseases. Children with medical complexity (CMC) are a high need, high cost population with [...]