Background: Skin and soft tissue infection (SSTI) is a common pediatric diagnosis with substantial economic cost. SSTIs vary in severity and clinical presentation. Providers often fear missing serious systemic infection, causing potential overtesting. However, recent studies suggest that blood cultures (BCx) are not useful in management of simple cellulitis or abscess (uncomplicated SSTIs [uSSTI]), and [...]

Background: Family members often play a significant role in the care of geriatric patients during and after hospitalization. Both patients and families have expectations for communication with the provider team in the acute setting, but navigating the flow of medical information across the family unit is challenging with current care models. Pediatric medicine recognizes that [...]

Background: Nationally, the number of adult patients (18+ years of age) with chronic congenital and childhood conditions being admitted to children’s hospitals has been increasing, and in some cases outpacing the rate of increase in pediatric admissions. This is secondary to advances in treatment of once-fatal conditions. Our institution is a quaternary referral center with [...]

Background: Transition from the inpatient to outpatient setting presents a safety risk to pediatric patients. Project IMPACT (Improving Pediatric Patient-Centered Care Transitions) is a multi-site quality improvement collaborative developed to improve the hospital to home transition for pediatric patients using a transition bundle. One bundle element is the use of teach-back (TB) to confirm caregiver [...]

Background: Inconsistent transitions of care from the inpatient to outpatient setting may lead to preventable readmissions. Critical processes completed at discharge shown to reduce readmissions at our institution include admission and discharge medication reconciliation, clinically appropriate follow-up scheduled prior to discharge, and timely completion of a discharge summary within 48 hours of discharge (the “Core [...]

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: 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 [...]

Background: The care of surgical patients is becoming more complex as patients with increasing comorbidities require surgical procedures. In adult hospital medicine, co-management of complex medical patients by hospital medicine and surgery has been shown to decrease length of stay and readmission for many procedures. It remains unclear, however, which patients are most likely to [...]

Background: Discharge education is a key component of safe transition from inpatient to outpatient care in the pediatric population. Project IMPACT (Improving Pediatric Patient-Centered Care Transitions) is a multi-site quality improvement project developed to improve care transitions for pediatric patients using a transition bundle. One bundle element focuses on thorough discharge education (DE) and the [...]

Background: The Joint Commission (TJC) included medication reconciliation (MedRec) as a 2005 National Patient Safety Goal to reduce errors related to medication omissions, duplications and interactions. Medication errors and harms continue to be one of the most widely reported healthcare problems. TJC’s sentinel event database includes > 350 medication errors resulting in death or major [...]