Background: Somatic Symptom and Related Disorders (SSRD) is an umbrella term for a wide variety of disorders commonly encountered in the inpatient pediatric setting, including conversion disorder, amplified pain syndrome, and psychogenic non-epileptiform seizures. These patients can be high utilizers of medical resources. The hospitalist is often charged with ruling out a medical diagnosis and [...]

Background: Somatic Symptom and Related Disorders (SSRD) is an umbrella term for a wide variety of disorders commonly encountered in the inpatient pediatric setting, including conversion disorder, amplified pain syndrome, and psychogenic non-epileptiform seizures. These patients can be high utilizers of medical resources. The hospitalist is often charged with ruling out a medical diagnosis and [...]

Background: Adolescent reproductive health education is essential to prevent transmission of sexually transmitted infections (STIs) and teen pregnancy. Half of all new STIs occur among 15-24 year-olds and 1 in 4 adolescent females has had an STI. In the United States, approximately 750,000 teenagers become pregnant per year. Adolescents are known to have poor access [...]

Background: In hospital-based medicine, maintaining an open line of communication between inpatient teams and community pediatricians serves as an essential component of providing comprehensive patient care and ensuring continuity at time of discharge. At St. Louis Children’s Hospital, inpatient resident teams are responsible for providing timely communication with community pediatricians regarding major patient events. Despite [...]

Background: The ACGME has developed competencies for systems-based practice and problem-based learning and improvement to encourage trainees to integrate quality and safety into their everyday practice. Furthermore, the AAMC has a call to action for US Medical schools and teaching hospitals to successfully align clinical and education missions in order to have quality improvement and [...]

Background: Third year medical students (MS3s) have not regarded the Pediatrics Clerkship at our institution with as high praise as other clerkships. Students cite a relative lack of teaching on the floors from pediatric residents as a key etiology. Interestingly, said residents endorse a desire to teach more. The most common barriers cited are time, [...]

Background: The 2011 AAP policy statement regarding recommendations for a safe infant sleeping environment included hospitalized infants, but unsafe sleep practices continue to be common in hospitalized infants. Safe sleep position compliance was observed to be low at Baystate Chidlren’s Hospital (BCH), as described in a prior abstract (http://abstract.staging.hospitalmedicine.org/abstract/improving-infant-safe-sleep-practices-in-the-inpatient-setting-using-qi-methodology/). Interventions designed to improve rates of [...]

Background: The Improving Pediatric Patient-Centered Care Transitions (IMPACT) multi-site quality improvement collaborative aims to improve discharge transitions by use of a transition bundle, including use of a discharge checklist (DCL) to ensure completion of important transition tasks. These tasks included identification of a primary care provider, establishing follow up appointments, and ensuring access to medications, [...]

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 [...]