Background: The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the United States, including changes in the care of hospitalized children. Our study aimed to identify the major changes in inpatient pediatric healthcare delivery and potential learnings from these changes. Methods: We conducted semi-structured interviews for this qualitative study. We purposefully sampled hospitals [...]

Background: A frequently cited challenge to parenting as a clinician relates to family leave policies. Taking parental leave may negatively affect clinicians’ income, research, career, and relationships with colleagues. Parental leave policies may be unfair, vague, or poorly communicated. We sought to describe the parental leave experiences and approaches used to support parental leave and [...]

Background: Pneumocystis pneumonia (PCP) is a life-threatening opportunistic infection that leads to severe pneumonia in immunocompromised hosts. This results in respiratory failure and hypoxemia. Its reported survival rate ranges from 20% to 50%. Despite its seriousness, there is limited research on the occurrence of PCP in children, likely due to its infrequency. Current national data [...]

Background: Children with medical complexity (CMC) are a growing pediatric population with disproportionately high health needs and costs often insured by Medicaid. Identification of CMC using complexity classification systems applied to population-level data and establishment of baseline patterns of population-level health care utilization are essential to target patients who may benefit most from complex care [...]

Background: Regionalization of pediatric healthcare has led to an increased proportion of hospitalizations at tertiary care centers and freestanding children’s hospitals. For some of these patients, transfer from another hospital is required to access inpatient care. There are known disparities in access to care for historically marginalized races/ethnicities, but it is unclear if these disparities [...]

Background: The three most common childhood-onset chronic conditions for which adolescents and young adults (YA) use pediatric hospitals are congenital heart disease (CHD), cystic fibrosis (CF), and sickle cell disease (SCD). Existing studies do not establish clear clinical benefits to continued pediatric hospitalization over hospitalization at adult hospitals. We aimed to determine if if continued [...]

Background: Approximately one-fourth of the estimated 676,000 children in the US who were victims of abuse and neglect in 2016 were less than 3 years of age. Fractures are a common manifestation of child abuse. To our knowledge, no research study to date has examined the factors associated with medical staff filing Department of Child [...]

Background: Pediatricians are mandated by law to report cases of suspected child abuse. The National Association of Children’s Hospitals and Related Institutions 2006 guidelines on the hospital’s role in child maltreatment note that children’s hospitals “are the undisputed leaders in providing medical care to abused and neglected children” and outline that hospitals should ensure that [...]

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 [...]

Case Presentation: A 2-year-old girl with a past medical history of hypertension and anterior mediastinal mass of unclear etiology presents to the ED with acute bruising. 2 months prior, she was admitted to PICU for fever and lethargy, AKI, hyperuricemia and electrolyte abnormalities concerning for tumor lysis syndrome (TLS), and was found to have a [...]