Background: Family centered rounds (FCR) was first defined by Sisterhen in 2007 as “interdisciplinary work rounds at the bedside in which patient and family share in the control of the management plan as well as in the evaluation of the process itself.”1 Since then, recognition of the benefits of FCR have led to widespread adoption. [...]

Background: Baystate Children’s Hospital serves a population that is vulnerable to unsafe sleep practices. By July 2017, there were 6 cases of accidental infant deaths in Hampden County MA, attributed to unsafe sleeping practices, primarily due to co-sleeping. In Springfield, MA, infant mortality rate (9.2%) is double that of the state rate (4.4%). Rates of [...]

Background: Medical students and interns are the primary communicators during pediatric patient- and family-centered rounds (PFCR). Presenter empowerment actions (PEAs) represent behaviors that empower presenters during PFCR to deliver effective, patient- and family-centered care. Third year (M3) and fourth year (M4) medical students are not formally trained on PEAs and their use of PEAs has [...]

Background: The clinical evaluation of febrile neonates ≤ 60 days has been extensively debated in the age of doing less invasive testing to yield the same clinical outcomes with fewer complications. Rates of serious bacterial infections (SBI) in this population have been reported to be between 8.5% and 12%, and up to 20% in neonates [...]

Background: In utero opioid exposure can result in neonatal abstinence syndrome (NAS). NAS incidence has increased five-fold in the last decade. NAS is a serious condition characterized by central nervous system hyperirritability and autonomic nervous system and gastrointestinal tract dysfunction. Newborns with NAS may have several potential complications, may require pharmacological management, have increased hospital [...]

Background: Asthma and bronchiolitis are the most common respiratory ailments affecting pediatric patients worldwide. Management guidelines have been developed in an effort to standardize the treatment of these patients. Nowhere in these guidelines (both the 2007 Expert Panel Report 3 Guidelines for the Management of Asthma and the 2014 American Academy of Pediatrics Guidelines for [...]

Background: Unrecognized in-hospital deterioration can lead to cardiac or respiratory arrests, and these events are often preventable. In pediatrics, in-hospital arrests are uncommon, making it difficult to identify risk factors or evaluate the success of interventions which aim to reduce unrecognized deterioration. In this study, we aimed to describe the demographic and clinical characteristics of [...]

Background: Many hospitals set targets for discharging patients before noon in efforts to optimize patient throughput. However, discharge before noon (DCBN) has been associated with increased length of stay (LOS) in an adult population. The relationship between discharge time of day and LOS in pediatric patients is uncertain. This study aims to evaluate the relationship [...]

Background: Constipation is a common pediatric complaint and cause of abdominal pain in the pediatric age group. Management for constipation is generally completed in the outpatient setting, but many patients may require inpatient management after failure of outpatient therapy. Methods: We utilized data from the 2012 Kids’ Inpatient Database (KID), a nationally representative sample of [...]

Background: Clinical Documentation Improvement programs have been present in adult hospitals for many years. These programs strive to promote clinicians working together with nurse specialists to appropriately depict the care delivered and increase coding accuracy. This collaboration has traditionally been through written and verbal documentation queries that clarify diagnoses based on a patient’s clinical indicators [...]