A Quality Improvement Initiative: Improving the Frequency of Inpatient Electronic Prescribing.

Abstract:

OBJECTIVE:To improve the frequency of electronic prescribing (e-prescribing) of discharge prescriptions at a children's hospital via a bundle of quality improvement interventions. METHODS:Surveys and focus groups were conducted with patient families and pediatric residents to identify barriers and propose solutions to e-prescribing. These data were used to generate a series of interventions, including the following: (1) provider education; (2) changes in patient registration workflow; and (3) electronic health record changes to improve the frequency of e-prescribing on the pediatric hospital medicine (PHM) service. The primary outcome measure was the e-prescribing frequency, with a balance measure of e-prescribing errors. RESULTS:From July 2014 through June 2015, e-prescribing frequency on the PHM service improved from a median of 7.4% to 48.9% (P < .001) and was sustained for an additional 6 months (July 2015-December 2015), surpassing meaningful use targets with associated US News and World Report hospital ranking points. The frequency of PHM prescription errors remained unchanged, and in comparison, the resident outpatient clinic revealed no statistically significant change in e-prescribing frequency during this time period. CONCLUSIONS:Engaging front-line providers in hospital-wide initiatives and quality improvement interventions can directly affect hospital metrics in programs such as meaningful use and US News and World Report, as shown through successful improvement in PHM e-prescribing frequency. Future studies are necessary to determine whether increased e-prescribing frequency affects patient outcomes and compliance.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Fuchs J,Lo HY,Peterman A,Camp E,Chase L

doi

10.1542/peds.2016-0760

subject

Has Abstract

pub_date

2016-11-01 00:00:00

issue

5

eissn

0031-4005

issn

1098-4275

pii

peds.2016-0760

journal_volume

138

pub_type

杂志文章
  • Reforming Medicaid for medically complex children.

    abstract::Children's hospitals play a central role in our child health care system. These hospitals face unique challenges under health care reform. They care for children with the most complex medical problems but often are not reimbursed for good preventive care, care coordination, or quality. We discuss a proposal by childre...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-0252g

    authors: O'Donnell R

    更新日期:2013-04-01 00:00:00

  • Physical fitness and activity in schools. American Academy of Pediatrics.

    abstract::Schools are in a uniquely favorable position to increase physical activity and fitness among their students. This policy statement reaffirms the American Academy of Pediatrics' support for the efforts of schools to include increased physical activity in the curriculum, suggests ways in which schools can meet their goa...

    journal_title:Pediatrics

    pub_type: 指南,杂志文章,实务指引

    doi:10.1542/peds.105.5.1156

    authors:

    更新日期:2000-05-01 00:00:00

  • Time for a new paradigm in pediatric medical education: teaching neonatal resuscitation in a simulated delivery room environment.

    abstract:OBJECTIVES:Acquisition and maintenance of the skills necessary for successful resuscitation of the neonate are typically accomplished by a combination of completion of standardized training courses using textbooks, videotape, and manikins together with active participation in the resuscitation of human neonates in the ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.4.e45

    authors: Halamek LP,Kaegi DM,Gaba DM,Sowb YA,Smith BC,Smith BE,Howard SK

    更新日期:2000-10-01 00:00:00

  • Guidelines for developing admission and discharge policies for the pediatric intensive care unit. American Academy of Pediatrics. Committee on Hospital Care and Section of Critical Care. Society of Critical Care Medicine. Pediatric Section Admission Crite

    abstract::These guidelines were developed to provide a reference for preparing policies on admission to and discharge from pediatric intensive care units. They represent a consensus opinion of physicians, nurses, and allied health care professionals. By using this document as a framework for developing multidisciplinary admissi...

    journal_title:Pediatrics

    pub_type: 指南,杂志文章

    doi:

    authors:

    更新日期:1999-04-01 00:00:00

  • Twenty-year trends in fatal injuries to very young children: the persistence of racial disparities.

    abstract:OBJECTIVE:Mortality trends across modifiable injury mechanisms may reflect how well effective injury prevention efforts are penetrating high-risk populations. This study examined all-cause, unintentional, and intentional injury-related mortality in children who were aged 0 to 4 years for evidence of and to quantify rac...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-2412

    authors: Pressley JC,Barlow B,Kendig T,Paneth-Pollak R

    更新日期:2007-04-01 00:00:00

  • Food protein-induced enterocolitis syndrome caused by solid food proteins.

    abstract:BACKGROUND:Infantile food protein-induced enterocolitis syndrome (FPIES) is a severe, cell-mediated gastrointestinal food hypersensitivity typically provoked by cow's milk or soy. Solid foods are rarely considered a cause. OBJECTIVE:To describe the clinical characteristics and natural history of FPIES provoked by soli...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.111.4.829

    authors: Nowak-Wegrzyn A,Sampson HA,Wood RA,Sicherer SH

    更新日期:2003-04-01 00:00:00

  • American Academy of Pediatrics. Policy statement--sexuality, contraception, and the media.

    abstract::From a health viewpoint, early sexual activity among US adolescents is a potential problem because of the risk of pregnancy and sexually transmitted infections. New evidence points to the media adolescents use frequently (television, music, movies, magazines, and the Internet) as important factors in the initiation of...

    journal_title:Pediatrics

    pub_type: 杂志文章,实务指引

    doi:10.1542/peds.2010-1544

    authors: Council on Communications and Media.

    更新日期:2010-09-01 00:00:00

  • Pulmonary embolism in the pediatric emergency department.

    abstract:OBJECTIVE:To describe patients who present to the pediatric emergency department (PED) and are subsequently diagnosed with pulmonary embolism (PE). METHODS:Electronic medical records from 2003 to 2011 of a tertiary care pediatric health care system was retrospectively reviewed to identify patients <21 years who had a ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-0126

    authors: Agha BS,Sturm JJ,Simon HK,Hirsh DA

    更新日期:2013-10-01 00:00:00

  • C-reactive protein in the diagnosis, management, and prognosis of neonatal necrotizing enterocolitis.

    abstract:OBJECTIVE:In this prospective, observational study, we determined whether serum C-reactive protein (CRP) correlated with necrotizing enterocolitis (NEC) stages II and III. We hypothesized that serial CRP measurement if used as an adjunct to abdominal radiographs would improve the identification of infants with NEC. ME...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-1806

    authors: Pourcyrous M,Korones SB,Yang W,Boulden TF,Bada HS

    更新日期:2005-11-01 00:00:00

  • Detection of Mycobacterium tuberculosis in clinical specimens from children using a polymerase chain reaction.

    abstract:OBJECTIVE:We evaluated the usefulness of the polymerase chain reaction (PCR) using the insertion sequence IS6110 as the target for DNA to detect Mycobacterium tuberculosis in clinical specimens from children. STUDY DESIGN:This was a prospective, controlled, blinded study comparing PCR on clinical specimens, mycobacter...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,多中心研究

    doi:

    authors: Smith KC,Starke JR,Eisenach K,Ong LT,Denby M

    更新日期:1996-02-01 00:00:00

  • Influenza burden for children with asthma.

    abstract:OBJECTIVE:The goal was to estimate the influenza disease burden among children with asthma and among healthy children by using active, laboratory-confirmed, population-based surveillance. METHODS:Children 6 to 59 months of age residing in 3 US counties who were hospitalized with acute respiratory illnesses or fever we...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-1053

    authors: Miller EK,Griffin MR,Edwards KM,Weinberg GA,Szilagyi PG,Staat MA,Iwane MK,Zhu Y,Hall CB,Fairbrother G,Seither R,Erdman D,Lu P,Poehling KA,New Vaccine Surveillance Network.

    更新日期:2008-01-01 00:00:00

  • The Dilemma of Predicting Violent Radicalization.

    abstract::Parents, educators, law enforcement officials, and health professionals are all concerned about the violent radicalization of adolescents. Health professionals may be called on to assess teenagers regarding the risk that they will become dangerous. We present a case in which a psychiatrist is asked to do a forensic ev...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-0685

    authors: Rousseau C,Ellis BH,Lantos JD

    更新日期:2017-10-01 00:00:00

  • Advanced Ultrasound Techniques for Pediatric Imaging.

    abstract::Ultrasound has become a useful tool in the workup of pediatric patients because of the highly convenient, cost-effective, and safe nature of the examination. With rapid advancements in anatomic and functional ultrasound techniques over the recent years, the diagnostic and interventional utility of ultrasound has risen...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2018-2609

    authors: Hwang M,Piskunowicz M,Darge K

    更新日期:2019-03-01 00:00:00

  • Human granulocytic ehrlichiosis presenting as abdominal pain.

    abstract::Human granulocytic ehrlichiosis (HGE) is an emerging infectious disease that primarily affects adults. Typical clinical features include fever, headache, and myalgias. This case represents the youngest reported patient with HGE. Her clinical presentation was unusual in that she presented with severe abdominal pain. In...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.3.602

    authors: Gershel JC

    更新日期:2000-09-01 00:00:00

  • Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic newborns.

    abstract:OBJECTIVE:To determine the sensitivity, specificity, predictive value, and accuracy of a program of pulse oximetry screening of asymptomatic newborns for critical congenital cardiovascular malformation (CCVM). METHODS:Pulse oximetry was performed on asymptomatic newborns in the well-infant nurseries of 2 hospitals. Ca...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.111.3.451

    authors: Koppel RI,Druschel CM,Carter T,Goldberg BE,Mehta PN,Talwar R,Bierman FZ

    更新日期:2003-03-01 00:00:00

  • Intrahepatic cholestasis associated with parenteral nutrition in premature infants.

    abstract::Sixty-two premature infants less than 2,000 gm birth weight received parenteral nutrition (PN) during periods of respiratory distress with feeding intolerance. Intrahepatic cholestasis (direct bilirubin greater than or equal to 1.5 mg/dl) associated with PN developed in 14 or 23% of these infants. The mean time on PN ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Beale EF,Nelson RM,Bucciarelli RL,Donnelly WH,Eitzman DV

    更新日期:1979-09-01 00:00:00

  • Status of newborn screening programs in the United States.

    abstract:BACKGROUND:Newborn screening programs have expanded over the years; currently, many programs screen for dozens of congenital conditions that, if not detected and treated early, could result in catastrophic health consequences, including death. Some programs, however, still require universal newborn screening for only a...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2005-2633C

    authors: Therrell BL,Johnson A,Williams D

    更新日期:2006-05-01 00:00:00

  • The use of a crystalline amino acid mixture for parenteral nutrition in low-birth-weight infants.

    abstract::Thirty-six preterm, sick, low-birth-weight neonates were given either total or partial parenteral nutrition. The patients were divided into three groups according to their birth weights: group A -less than 1,000 gm, 12 patients: group B--between 1,000 and 1,500 gm, 15 patients: group C--more than 1,500 gm, 9 patients....

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Meng HC,Stahlman MT,Otten A,Dolanski EA,Caldwell MD,O'Neill JA

    更新日期:1977-05-01 00:00:00

  • Adverse effects in children after unintentional buprenorphine exposure.

    abstract::Buprenorphine in sublingual formulation was recently introduced to the American market for treatment of opioid dependence. We report a series of 5 toddlers with respiratory and mental-status depression after unintentional buprenorphine exposure. Despite buprenorphine's partial agonist activity and ceiling effect on re...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-0948

    authors: Geib AJ,Babu K,Ewald MB,Boyer EW

    更新日期:2006-10-01 00:00:00

  • Diabetes in Pregnancy and Childhood Cognitive Development: A Systematic Review.

    abstract:CONTEXT:The effect of diabetes during pregnancy on the cognitive development of offspring is unclear because of inconsistent findings from limited studies. OBJECTIVE:This review was aimed to provide the best available scientific evidence on the associations between maternal pregnancy diabetes and the cognitive develop...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2015-4234

    authors: Adane AA,Mishra GD,Tooth LR

    更新日期:2016-05-01 00:00:00

  • Psychologic adjustment of the family with a member who has cystic fibrosis.

    abstract::Seventy-eight percent of the 384 patients 2 years of age and older who were enrolled in the Cystic Fibrosis Clinic at the Hospital for Sick Children participated in this study of family adjustment to cystic fibrosis. Residence with at least one parent at the time of the survey was a condition for inclusion in the stud...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Cowen L,Mok J,Corey M,MacMillan H,Simmons R,Levison H

    更新日期:1986-05-01 00:00:00

  • Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F).

    abstract:OBJECTIVE:This study validates the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F), a screening tool for low-risk toddlers, and demonstrates improved utility compared with the original M-CHAT. METHODS:Toddlers (N = 16,071) were screened during 18- and 24-month well-child care visits in m...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-1813

    authors: Robins DL,Casagrande K,Barton M,Chen CM,Dumont-Mathieu T,Fein D

    更新日期:2014-01-01 00:00:00

  • Fatal myocardial infarction following therapy with prothrombin complex concentrates in a young man with hemophilia A.

    abstract::A fatal myocardial infarction in a 22-year-old man with hemophilia A and a factor VIII inhibitor is described. The catastrophic event occurred while the patient was receiving high doses of unactivated prothrombin complex concentrates. Autopsy examination revealed myocardial hemorrhage with no evidence of coronary arte...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Sullivan DW,Purdy LJ,Billingham M,Glader BE

    更新日期:1984-08-01 00:00:00

  • Discordance between male and female deaths due to the respiratory distress syndrome.

    abstract::General neonatal mortality statistics and those for the respiratory distress syndrome (RDS) were examined for the State of Wisconsin from 1979 through 1982. The objectives were to ascertain whether there are differences in total neonatal mortality related to sex and birth weight, to determine the veracity of reported ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Perelman RH,Palta M,Kirby R,Farrell PM

    更新日期:1986-08-01 00:00:00

  • Relative effects of drugs and diet on hyperactive behaviors: an experimental study.

    abstract::In a test of Feingold's hypothesis that food additives trigger the hyperactive response, 26 hyperactive children were randomly assigned to treatment conditions whereby they were given active or placebo medications in combination with challenge cookies with artificial food colors or control cookies without the additive...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Williams JI,Cram DM,Tausig FT,Webster E

    更新日期:1978-06-01 00:00:00

  • Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum.

    abstract:OBJECTIVE:The population subgroups with the highest proportion of overweight and obese women often are characterized by the lowest rates of initiation and shortest durations of breastfeeding. We previously documented that these 2 population-level trends may be related. In a population of white women who lived in a rura...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.113.5.e465

    authors: Rasmussen KM,Kjolhede CL

    更新日期:2004-05-01 00:00:00

  • The Cockayne syndrome: an evaluation of hypertension and studies of renal pathology.

    abstract::Three children with renal disease, hypertension, and the Cockayne syndrome were evaluated. All patients had severe hypertension; peripheral vein renin was elevated in two patients. Renal biopsy specimens from two patients were studied by light microscopy, electron microscopy, and immunofluoresence. Immunohistologic st...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Higginbottom MC,Griswold WR,Jones KL,Vasquez MD,Mendoza SA,Wilson CB

    更新日期:1979-12-01 00:00:00

  • Tracking of BMI z Scores for Severe Obesity.

    abstract:BACKGROUND:Although the Centers for Disease Control (CDC) growth charts are widely used in studies of childhood obesity, BMI z scores are known to be inaccurate at values greater than the 97th percentile. METHODS:We used longitudinal data from 6994 children in the Bogalusa Heart Study who were examined multiple times ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-1072

    authors: Freedman DS,Berenson GS

    更新日期:2017-09-01 00:00:00

  • Medical conditions affecting sports participation.

    abstract::Children and adolescents with medical conditions present special issues with respect to participation in athletic activities. The pediatrician can play an important role in determining whether a child with a health condition should participate in certain sports by assessing the child's health status, suggesting approp...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2008-0080

    authors: Rice SG,American Academy of Pediatrics Council on Sports Medicine and Fitness.

    更新日期:2008-04-01 00:00:00

  • Routine admission urinalysis examination in pediatric patients: a poor value.

    abstract::The urinalysis has long been considered an important screening test for hospitalized children. The value of the admission urinalyses, required by hospital bylaws, was assessed for detecting urinary tract disease in children admitted to a day-care unit or impatient medical or surgical services during the months of June...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Mitchell N,Stapleton FB

    更新日期:1990-09-01 00:00:00