Abstract:
OBJECTIVE:Primary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determine ways to improve communication and remove barriers by eliciting the perspectives of pediatric PCPs and hospitalists. METHODS:Using qualitative methods, 2 sets of focus groups were held: 1) mix of local PCPs serving diverse populations, and 2) hospitalists from a free-standing, pediatric institution. The open-ended, semistructured question guides included questions about communication experiences, patient care responsibilities, and suggestions for improvement. Using inductive thematic analysis, investigators coded the transcripts, and resolved differences through consensus. RESULTS:Six PCP (n = 27) and 3 hospitalist (n = 15) focus groups were held. Fifty-six percent of PCPs and 14% of hospitalists had been practicing for >10 years. Five major themes were identified: problematic aspects of communication, perceptions of provider roles, push-pull, postdischarge responsibilities/care, and proposed solutions. Aspects of communication included specific problem areas with verbal and written communication. Perceptions of provider roles highlighted the issue of PCPs feeling devalued. Push-pull described conflicting expectations about a counterpart's role and responsibilities. Postdischarge responsibilities/care addressed unclear responsibilities related to patient follow-up. Proposed solutions were suggested for ways to improve communication. CONCLUSIONS:Deficiencies in communication hinder successful collaboration and can cause tension between providers in inpatient and outpatient settings. Understanding specific issues that contribute to poor communication like perceptions about provider roles is critical to improving relationships and facilitating combined efforts to improve patient care.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Solan LG,Sherman SN,DeBlasio D,Simmons JMdoi
10.1016/j.acap.2016.03.003subject
Has Abstractpub_date
2016-07-01 00:00:00pages
453-459issue
5eissn
1876-2859issn
1876-2867pii
S1876-2859(16)30045-6journal_volume
16pub_type
杂志文章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:OBJECTIVE:To estimate the prevalence of use of fetal-harm drugs among women who received postpartum care in hospitals in Haiti and to identify groups of women at higher risk for potentially harmful medication exposures. METHODS:Women who received postpartum care in 2 large hospitals in Port-au-Prince, Haiti, from Augu...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.09.003
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To prevent iron deficiency, 2014 Canadian recommendations for healthy term infants from 6 to 24 months recommend iron-rich complementary foods such as meat and meat alternatives 2 or more times a day. The purpose of our study was to evaluate the association between meat and meat-alternative consumption and ir...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.01.003
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:Diagnostic errors (DEs), which encompass failures of accuracy, timeliness, or patient communication, cause appreciable morbidity but are understudied in pediatrics. Pediatricians have expressed interest in reducing high-frequency/subacute DEs, but their epidemiology remains unknown. The objective of this stud...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.08.005
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:We aimed to examine abusive head trauma (AHT) incidence before, during and after the recession of 2007-2009 in 3 US regions and assess the association of economic measures with AHT incidence. METHODS:Data for children <5 years old diagnosed with AHT between January 1, 2004, and December 31, 2012, in 3 region...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.05.008
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:In October 2016, the American Board of Medical Specialties approved the petition for pediatric hospital medicine (PHM) to become the newest pediatric subspecialty. Knowledge about residents entering the PHM workforce is needed to inform certification and fellowship accreditation. This study describes the char...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.05.001
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:We sought to determine the age at which US parents first turned their child's car seat to face forward and information sources used to make that decision at the time of the release of the 2011 guidelines for child passenger safety and 30 months later. METHODS:We administered 2 separate cross-sectional Web-ba...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2014.10.004
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:There are limited training opportunities for pediatricians in caring for children with medical complexity (CMC) in the home and community. Prior studies have described a lack of comfort caring for CMC among pediatric residents. OBJECTIVE:1) To evaluate the impact of participation in a virtual home visit cur...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.05.001
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Peer victimization is a common antecedent of poor social and emotional adjustment. Its relationship with objectively measured academic performance is unclear. In this study we aimed to quantify the cross-sectional associations between peer victimization and academic performance in a large population sample of...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.06.012
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:There has been a rapid increase in the number of pediatric hospitalist programs in the United States. As most pediatric hospitalist services are believed to be subsidized by hospitals, gaining a better understanding of the rationale for these subsidies is critical to the future success and existence of these ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.01.003
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Given the high prevalence of asthma and obesity in minority children, there is a need to identify targets for intervention to decrease the impact of these conditions on children's functioning in this high-risk group. OBJECTIVE:To examine in urban children with persistent asthma, 1) differences in asthma ind...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.07.001
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Underreporting of adverse events by physicians is a barrier to improving patient safety. In an effort to increase resident and medical student (hereafter "trainee") reporting of adverse events, trainees developed and led a monthly conference during which they reviewed adverse event reports (AERs), identified ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.01.004
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:Depression among adolescents is a leading public health problem. Although screening for adolescent depression in primary care is strongly recommended, screening rates remain low. Effective quality improvement (QI) initiatives can facilitate change. This study aims to assess the impact of a QI learning collabo...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.02.014
更新日期:2019-01-01 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:Fewer than 50% of children with developmental delay are identified before they start school, and only 10% of those identified receive services. Between May 2014 and August 2016, the Home Visiting Collaborative Improvement and Innovation Network (HV-CoIIN) aimed to improve early detection and linkage to servic...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.08.020
更新日期:2020-09-03 00:00:00
abstract::The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This li...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2016.01.014
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To evaluate whether primary care provider (PCP) access to an online decision support tool is associated with a change in evidence-based primary care medical management of pediatric migraine. METHODS:In this prospective observational study, PCPs serving a target community were educated on the availability and...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.11.017
更新日期:2020-08-01 00:00:00
abstract::Over the past 30 years, there have been major expansions in public health insurance for low-income children in the United States through Medicaid, the Children's Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affor...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.12.011
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To determine the proportion of abstracts submitted to the 2010 Pediatric Academic Societies (PAS) meeting that were exclusively qualitative, and to examine whether these abstracts were more or less likely than all others to be designated as platform, poster, or publish only. METHODS:The database of abstracts...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.01.007
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the percentage of hospitals with adequate sample size to meaningfully compare performance by using the Agency for Healthcare Research and Quality (AHRQ) pediatric quality indicators (PDIs), which measure pediatric inpatient adverse events such as decubitus ulcer rate and...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.04.025
更新日期:2010-07-01 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::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::All medical educators have experienced "teachable moments" during their career, and most can likely share examples of these moments from both training and their role as educators. In addition, most if not all have faced a situation in which an educational opportunity fell short or was missed entirely. This View from t...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.08.011
更新日期:2020-08-20 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:Although it is known that children with mental health problems utilize primary care services more than most other children, it is unknown how addressing mental health problems in primary care affects children's subsequent services utilization. This study measures primary care utilization in the context of a r...
journal_title:Academic pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.acap.2010.06.012
更新日期:2010-09-01 00:00:00
abstract::Population health is associated with the socioeconomic characteristics of neighborhoods. There is considerable scientific and policy interest in community-level interventions to alleviate child poverty. Intergenerational poverty is associated with inequitable access to opportunities. Improving opportunity structures w...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2016.01.013
更新日期:2016-04-01 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:Youth involvement in extracurricular activities may help prevent smoking and drinking initiation. However, the relative roles of types of extracurricular activity on these risks are unclear. Therefore, we examined the association between substance use and participation in team sports with a coach, other sport...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2014.02.002
更新日期:2014-05-01 00:00:00
abstract::When Congress reenacted the Child Health Insurance Program (CHIP) in 2009, it incorporated a range of dental provisions that had not been considered when the program was initiated in 1997. This paper posits that this change evidences the establishment of pediatric oral health as a distinct policy issue within Congress...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.09.002
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To evaluate how parents and physicians perceive the utility of a comprehensive, electronic previsit screener, and to assess its impact on the visit. METHODS:A mixed methods design was used. English-speaking parents were recruited from 3 primary care systems (urban MD and rural NY and VT) when they presented ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.04.005
更新日期:2013-07-01 00:00:00