Abstract:
:Four evaluations of ambulatory pediatric tasks were used for quality assurance in eight pediatric group practices situated in two teaching hospitals and six related health centers. The evaluations used criteria incorporating branching logic to judge the quality of care revealed in data abstracted from medical records. Performance was evaluated for follow-up of positive urine cultures, assessment and follow-up of otitis media, initial assessment for gastroenteritis, and "well child" care for infants. A computerized data system was developed to process evaluation data and produce easily read reports. This work is part of a controlled trial of the feasibility, cost, and effectiveness of quality assurance as a means to improve patient care, but this preliminary report concerns only the principles for design of the evaluations and their use in quality assurance. Acceptance of evaluations by site providers was high: of 203 provider responses to a survey, only four reported disagreement with the criteria. Rates of cases "variant" from criteria and found on peer review to represent deficiencies in care, when averaged across sites, ranged by task from 1% to 47% of cases evaluated. In most sites, providers planned and implemented actions to correct these deficiencies. It is noted that improvements in care may increase costs of care.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Palmer RH,Strain R,Maurer JV,Thompson MSsubject
Has Abstractpub_date
1984-03-01 00:00:00pages
269-77issue
3eissn
0031-4005issn
1098-4275journal_volume
73pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::Clinicians have been faced with much publicity and contradictory scientific evidence regarding a recently described condition termed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). It has been proposed that children with PANDAS experience tics, obsessive-compulsive beh...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.113.4.883
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Trampoline parks, indoor recreational facilities with wall-to-wall trampolines, are increasing in number and popularity. The objective was to identify trends in emergency department visits for trampoline park injuries (TPIs) and compare TPI characteristics with home trampoline injuries (HTIs). ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-1236
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The serum electrolyte panel (SEP) is a frequently ordered laboratory test, but it has unproven usefulness in the treatment of dehydrated pediatric patients. Our study purpose was to evaluate the usefulness of routinely ordering a SEP in the treatment of dehydrated pediatric patients receiving intravenous flu...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-0457
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVES:We sought to determine factors that would predict the development of subglottic stenosis (SGS) and tracheomalacia (TM) in preterm infants. The utility of a semiquantitative measurement of airway dimensions was assessed in relation to signs of airway complications. We also sought to determine from a high-risk...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::Atlantoaxial instability is a relatively frequent finding in individuals with Down syndrome. We examined 404 patients with this chromosome disorder and observed their atlanto-dens intervals and spinal canal widths to be significantly different from children without Down syndrome. Significant differences were also note...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::Sarcosinemia has been detected by routine screening of urine for metabolic and transport disorders in Massachusetts. Three infants who had sarcosinemia were detected through the neonatal urine specimen, an observed incidence of 1:350,000. A fourth child had sarcosinemia detected through family screening after his brot...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVE:To identify possible causes of suboptimal glycemic control (ascertained by hemoglobin A1c [HbA1c] level) in youths using insulin pump therapy. METHODS:Forty-eight youths who were receiving insulin pump therapy for > or =6 months, and who were using insulin pumps and blood glucose meters with data that could ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.113.3.e221
更新日期:2004-03-01 00:00:00
abstract:CONTEXT:Recombinant human erythropoietin (rhEPO) is a promising pharmacological agent for neuroprotection in neonates. OBJECTIVE:To investigate whether prophylactic rhEPO administration in very preterm infants improves neurodevelopmental outcomes in a meta-analysis of randomized controlled trials (RCTs). DATA SOURCES...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1542/peds.2016-4317
更新日期:2017-05-01 00:00:00
abstract:CONTEXT:Severe combined immunodeficiency (SCID) is a group of disorders that leads to early childhood death as a result of severe infections. Recent research has addressed potential newborn screening for SCID. OBJECTIVE:To conduct a systematic review of the evidence for newborn screening for SCID, including test chara...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2009-1567
更新日期:2010-05-01 00:00:00
abstract:CONTEXT:The effectiveness of many interventions aimed at reducing the risk of retinopathy has not been well established. OBJECTIVE:To estimate the effectiveness of nutritional interventions, oxygen saturation targeting, blood transfusion management, and infection prevention on the incidence of retinopathy of prematuri...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1542/peds.2015-3387
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To systematically review the evidence to determine whether the routine use of high-frequency oscillatory ventilation (HFOV) as compared with conventional ventilation (CV) is beneficial or harmful in preterm infants requiring mechanical ventilation for pulmonary failure principally due to respiratory distress...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析
doi:10.1542/peds.100.5.e6
更新日期:1997-11-01 00:00:00
abstract::Neonatal hyperviscosity syndrome is known to affect multiple organ systems. The effects of polycythemic hyperviscosity on cutaneous blood flow and transcutaneous PO2 and PCO2 were compared in ten term infants prior to and following correction of the hyperviscous state. Cutaneous blood flow was measured by the heat cle...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:There is an increase in the incidence of type 2 diabetes in children and adolescents. Absence of known diabetes autoimmune markers is sometimes required to confirm the diagnosis. OBJECTIVE:To identify clinical and autoimmune characteristics of type 2 diabetes in a pediatric population. METHOD:We report an ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.107.6.e102
更新日期:2001-06-01 00:00:00
abstract:CONTEXT:Evidence is emerging that preterm infants are at risk for autism spectrum disorder (ASD). OBJECTIVES:To conduct a systematic review and meta-analysis to estimate the prevalence of ASD in preterm infants. DATA SOURCES:Medline (via PubMed and Ovid), Embase, PsycINFO, and relevant conference proceedings were sea...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析
doi:10.1542/peds.2018-0134
更新日期:2018-09-01 00:00:00
abstract::In 2016, the American Academy of Pediatrics published a clinical practice guideline that more specifically defined apparent life-threatening events as brief resolved unexplained events (BRUEs) and provided evidence-based recommendations for the evaluation of infants who meet lower-risk criteria for a subsequent event ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-4101
更新日期:2019-08-01 00:00:00
abstract::In the ideal situation, the evaluation for sepsis in the young infant should include collection of multiple blood cultures before the institution of antibiotics. Unfortunately, in some infants, it may not be possible to obtain more than a single blood culture at the time of initial evaluation. If this single culture u...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVE:To characterize the clinical spectrum and epidemiology of invasive Kingella kingae infections in children living in southern Israel. DESIGN:Five-year observational, descriptive study. POPULATION:Children in whom K. kingae was isolated from blood or other normally sterile body fluid. RESULTS:Twenty-five pat...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::L.L. Stephens described several critical issues in medical professionalization. The encounter with morbidity and mortality heightens the student's feelings of vulnerability. If he over-identifies with patients, he may suffer more and be unable to provide rational medical care. If he protects himself by dehumanizing pa...
journal_title:Pediatrics
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract:OBJECTIVES:Multisystem inflammatory syndrome in children (MIS-C) has spread through the pediatric population during the coronavirus disease 2019 pandemic. Our objective for the study was to report the prevalence of conduction anomalies in MIS-C and identify predictive factors for the conduction abnormalities. METHODS:...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2020-009738
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of an emergency department (ED)-based home safety intervention on caregivers' behaviors and practices related to home safety. METHODS:We conducted a randomized, clinical trial of 96 consecutive caregivers of children who were younger than 5 years and presented to an urban pediatri...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1542/peds.113.6.1603
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:Pediatric obstructive sleep apnea syndrome (OSAS) is associated with neurocognitive and endothelial dysfunction. However, it is unclear whether these 2 frequent morbidities of OSAS in children represent similar or different underlying pathophysiological processes, because they have never been concurrently ass...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-0688
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Our objective was to conduct a pilot study to identify discriminating bruising characteristics and to model those findings into a decision tool for screening children at high risk for abuse. METHODS:A case-control study of children 0 to 48 months of age who were admitted to a PICU because of trauma was perfo...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-3632
更新日期:2010-01-01 00:00:00
abstract::Review of North Carolina traffic crash data revealed that alcohol use, although associated with 7.9% of motor vehicle crashes involving children, accounted for 15.4% of the motor vehicle-related deaths and 10.4% of the injuries. The largest proportion of these deaths were child passengers in a vehicle in which the dri...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::Dietary patterns and racial differences in nutrient intake were observed in children 6 months to 4 years of age in the Bogalusa Heart Study. Even in this sample of young children, the composition of the intakes of the majority of children was not compatible with prudent recommendations of less than 35% and 10% of ener...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:The goal was to determine the impact of a community-wide educational intervention on parental misconceptions likely contributing to pediatric antibiotic overprescribing. METHODS:We conducted a cluster-randomized trial of a 3-year, community-wide, educational intervention directed at parents of children < 6 y...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2006-2600
更新日期:2007-04-01 00:00:00
abstract::Schools offer an opportunity to deliver new vaccines to adolescents who may not receive them in their medical home. However, school budgets and health priorities are set at the local level; consequently resources devoted to health-related activities vary widely. Partnering with schools requires soliciting buy-in from ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-1115F
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To determine physician-administered influenza vaccine coverage for children aged 6 to 23 months in a jurisdiction with a universal influenza immunization program during 2002-2009 and to describe predictors of vaccination. METHODS:By using hospital records, we identified all infants born alive in Ontario hos...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-2441
更新日期:2012-06-01 00:00:00
abstract::The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, underst...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2014-0881
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:Renovascular disease accounts for the vast majority of cases of infantile hypertension with complications resulting from umbilical arterial catheterization predominating in the neonatal period and fibrodysplastic lesions of the renal artery predominating outside the neonatal period. We report a previously ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.103.5.e66
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media. DESIGN:Randomized, multicenter, investigator-blinded. SETTING:Outpatient. PATIENTS:A total of 368 patients (age 2 months to 17 years) were randomized to receive either cefpodoxim...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-12-01 00:00:00