Abstract：
BACKGROUND AND OBJECTIVE:Patients with limited English proficiency (LEP) experience worse health care outcomes compared to English proficient (EP) patients, and professional interpretation is underutilized in clinical settings. The objectives of this study were to describe patterns of interpreter use in a pediatric emergency department (ED), to determine factors associated with its use, and to examine differences in outcomes between EP families and those with LEP. METHODS:ED encounters for LEP and EP patients were reviewed in a retrospective cohort study design over a 15 month period. Generalized estimating equations were used to compare patient encounters and factors associated with interpreter use. RESULTS:Interpreter use for families who preferred a non-English language was 45.4%. Use of interpretation was less likely during busier times of day (odds ratio [OR] 0.85, confidence interval [CI] 0.78-0.93), with a lower triage acuity (OR 0.66, CI 0.62-0.70), and with each increasing year of patient age (OR 0.97, CI 0.96-0.98). LEP patients who did not receive interpretation were less likely to be admitted than EP patients (OR 0.69, 0.62-0.78). Patients of LEP families, with or without interpretation, were more likely to be transferred to the ICU within 24 hours of admission than patients of EP families (OR 1.76, 1.07-2.90; 1.85, 1.08-3.18) suggesting that an aspect of clinical severity may have been missed in the ED. CONCLUSIONS:Professional interpretation is currently underutilized in this ED for patients with LEP, and important differences in outcomes exist between LEP and EP patients. Factors associated with interpreter use will inform ongoing improvement efforts.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Hartford EA,Anderson AP,Klein EJ,Caglar D,Carlin K,Lion KCdoi
10.1016/j.acap.2019.07.006subject
Has Abstractpub_date
2019-01-01 00:00:00pages
956-962issue
8eissn
1876-2859issn
1876-2867pii
S1876-2859(18)30620-Xjournal_volume
19pub_type
杂志文章abstract：BACKGROUND:The American Board of Pediatrics requires that pediatricians be able to initiate stabilization of a newborn. After residency, 45% of general pediatricians routinely attend deliveries. However, there is no standard approach or tool to measure resident proficiency in newborn resuscitation across training progr...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.09.004
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVE:Burnout is a work-related syndrome characterized by emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA). We hypothesized that the transition into an environment of high physical, intellectual, and emotional demands of the medical profession would lead to an increase in ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2013.12.001
更新日期：2014-03-01 00:00:00
abstract：OBJECTIVE:Pregnancy is common during residency, yet the duration of allowed paid leave is inadequate and utilizing unpaid family medical leave act (FMLA) time has financial and professional consequences. We evaluated the effectiveness of a novel parenting elective, consistent with educational goals for pediatric reside...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.02.008
更新日期：2020-07-01 00:00:00
abstract：OBJECTIVE:To describe influences on shared decision making between primary care pediatricians and parents of young children with autism spectrum disorder (ASD). METHODS:We conducted a qualitative study using key informant interviews with 20 pediatricians of varying experience from 10 primary care practices and 20 Engl...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.04.007
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:The role of a hospitalist differs in a community hospital (CH) compared to a university/children's hospital. Residents are required to practice in a variety of relevant clinical settings, but little is known about current trends regarding pediatric resident training in different hospital settin...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.10.006
更新日期：2020-03-01 00:00:00
abstract：OBJECTIVE:To examine the prevalence of positive screening scores, construct validity, and opportunities for follow-up in a large sample of adolescents who chose to fill out the Pediatric Symptom Checklist-Youth Form (PSC-Y) through the Mental Health America (MHA) Web site. METHODS:MHA sent researchers a deidentified d...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.08.013
更新日期：2018-01-01 00:00:00
abstract：:Electronic medical records (EMRs) are increasingly common in pediatric patient care. EMR data represent a relatively novel and rich resource for clinical research. The fact, however, that pediatric EMR data are collected for the purposes of clinical documentation and billing rather than research creates obstacles to t...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2011.02.007
更新日期：2011-07-01 00:00:00
abstract：OBJECTIVE:Incorporating culturally sensitive care into well-child visits may help address pediatric preventive care disparities faced by racial and ethnic minorities, families with limited English proficiency, and immigrants. We explored parents' perspectives about the extent to which their children's pediatric care is...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.12.007
更新日期：2020-03-01 00:00:00
abstract：:Management of referral and consultation is an entrustable professional activity for pediatric residents; however, few tools exist to teach these skills. We designed and implemented tools to prompt discussion, feedback, and reflection about the process of referral, notably including the family's perspective. ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.01.010
更新日期：2018-04-01 00:00:00
abstract：:Primary care pediatricians and psychology practitioners who comanage mental health problems can develop interdisciplinary communication and collaborative skills from joint standardized patient encounters and debriefings, combined with brief didactics. Learners showed increased confidence in shared management of behavi...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.06.014
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:To examine the relationship between continuity of care for children with medical complexity (CMC) and emergency department (ED) utilization, care coordination quality, and family effects related to care coordination. METHODS:We measured ED utilization and primary care continuity with the Bice-Boxerman contin...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.04.009
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVE:A cluster randomized trial was performed to evaluate an educational intervention to improve parental attitudes and vaccine uptake in vaccine-hesitant parents. METHODS:Two primary care sites were randomized to provide families with either usual care or an intervention (video and written information) for vacci...
journal_title：Academic pediatrics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.acap.2013.03.011
更新日期：2013-09-01 00:00:00
abstract：:Neonatal intensive care unit networks that encompass regions, states, and even entire countries offer the perfect platform for implementing continuous quality improvement initiatives to advance the health care provided to vulnerable neonates. Through cycles of identification and implementation of best available eviden...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2013.04.014
更新日期：2013-11-01 00:00:00
abstract：OBJECTIVE:Since the introduction of resident work-hour standards, pediatric residency programs have struggled to preserve robust continuity clinic experiences. Many programs have resorted to more flexible approaches to resident scheduling. We know little regarding the impact of such changes. We compared 2 continuity cl...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2009.11.002
更新日期：2010-03-01 00:00:00
abstract：OBJECTIVE:To evaluate a pediatric otoscopy curriculum with the use of outcome measures that included assessment of skills with real patients. METHODS:Thirty-three residents in an intervention group from 2 institutions received the curriculum. In the previous year, 21 residents in a nonintervention group did not receiv...
journal_title：Academic pediatrics
pub_type： 杂志文章,多中心研究
doi：10.1016/j.acap.2018.02.009
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVES:The cognitive expertise of Pediatric Hospitalists (PH) lies not in standard knowledge but in making decisions under conditions of uncertainty. To maintain expertise, PH should engage in deliberate practice via self-assessments that promote higher-level cognitive processes necessary to address problems with m...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.10.003
更新日期：2020-10-14 00:00:00
abstract：OBJECTIVE:There are many studies of the Pediatric Symptom Checklist (PSC), but none has followed a naturalistic sample longitudinally. We aimed to examine persistence and change in PSC scores over time in children seen in an ambulatory pediatric setting. METHODS:The sample of 1033 patients was PSC screened at 2 consec...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2009.03.004
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Provider elicitation of parent developmental and behavioral (DB) concerns is the foundation of DB surveillance. Language differences may affect whether providers assess parental DB concerns. OBJECTIVE:The aim of this study was to compare children in English versus Spanish primary language households by risk...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2008.12.006
更新日期：2009-03-01 00:00:00
abstract：OBJECTIVE:Guidelines recommend closer outpatient follow-up for exclusively breastfed newborns, especially those with pronounced weight loss, because of increased risk of hyperbilirubinemia and dehydration that might require readmission. Our objective was to determine how feeding method and weight loss are associated wi...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.11.005
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Children and adolescents necessitating hospitalization for physical health conditions are at high risk for mental health conditions; however, the prevalence of mental health conditions and symptoms among hospitalized children and adolescents is uncertain. The objective of this study was to determine the prop...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.08.009
更新日期：2017-03-01 00:00:00
abstract：OBJECTIVE:To compare the prevalence of a medical home for children with public versus private insurance and identify components of the medical home that contribute to any differences. METHODS:We performed a secondary data analysis of the 2007 National Survey of Children's Health. A medical home was defined as meeting ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2011.03.006
更新日期：2011-07-01 00:00:00
abstract：BACKGROUND:Adults tend to underestimate their personal risk of disease, but little is known about parents' perceptions of children's risk. METHODS:In total, 648 parents of children 0 to 18 years old attending 2 pediatric practices were surveyed about their children's exposure to smoking; 344 parents with children ≥2 y...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.09.008
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVE:To understand why families enroll in and disenroll from Children's Health Insurance Program (CHIP), their experience with the CHIP application and renewal process, and the insurance coverage of their children after disenrolling. METHODS:We conducted a large household telephone survey in 2012 of CHIP enrollee...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2015.02.013
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVE:Literacy promotion is a pediatric standard of care in which clinicians provide guidance on shared reading. Latino parents are more likely to hear advice to read with children but are less likely to do so. We sought to understand literacy promotion from the perspective of Latino parents and to identify facilit...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.08.003
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:The demand for global health electives among medical students and residents has grown substantially, yet perspectives of international hosts are not well documented. This study aimed to assess how host country supervising clinical preceptors perceive learners on short-term global health electives of up to 6 w...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2015.11.002
更新日期：2016-05-01 00:00:00
abstract：OBJECTIVE:To assess primary care providers' current reminder/recall practices, preferences for collaboration with health departments in reminder/recall efforts, attitudes toward practice-based and population-based reminder/recall, and experiences with a population-based reminder/recall intervention. METHODS:Providers ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2013.09.003
更新日期：2014-01-01 00:00:00
abstract：:Tobacco use is the leading cause of preventable death in the United States, and exposure to tobacco smoke harms children from conception forward. There is no safe level of tobacco exposure. Although overall smoking rates have declined, the advent of new products, such as electronic cigarettes, threatens to perpetuate ...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2016.12.010
更新日期：2017-04-01 00:00:00
abstract：:Though the use of mobile devices (e.g., tablets, smartphones) by young children is pervasive and increasing, research relating children's use of mobile devices to their development is only beginning to emerge. Learning, language development, and self-regulation skills among children aged zero to five are of particular...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2021.01.007
更新日期：2021-01-21 00:00:00
abstract：OBJECTIVE:To evaluate the effects of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation rates. METHODS:Twenty-nine pediatric HCPs serving 5 pediatric clinics were randomized to 1 of 3 arms: 1) usual practice control, 2) simple reminder prompt, and 3) elab...
journal_title：Academic pediatrics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.acap.2017.11.002
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVE:The Core Entrustable Professional Activities for Entering Residency (Core EPAs) were developed to address the gap between medical school and residency. There is a lack of instruments to measure performance of the Core EPAs in clerkships. We describe the operationalization and outcomes of a workplace-based ass...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.09.016
更新日期：2020-10-07 00:00:00
