Abstract:
:Children's hospitals and their affiliated departments of pediatrics often pursue separate programs in quality and safety; by integrating these programs, they can accelerate progress. Hospital executives and pediatric department chairs from 14 children's hospitals have been exploring practical approaches for integrating quality programs. Three components provide focus: (1) alignment of quality priorities and resources across the organizations; (2) education and training for physicians in the science of improvement; and (3) professional development and career progression for physicians in recognition of quality-improvement activities. Process and resource requirements are identified for each component, and specific, actionable steps are identified. The action steps are arrayed on a continuum from basic to advanced integration. The resulting matrix serves as an "integration framework," useful to a hospital and its pediatric academic department at any stage of integration for assessing its current state, plotting a path toward further integration, tracking its progress, and identifying potential collaborators and models of advanced integration. The framework contributes to health care's quality-improvement movement in multiple ways: it addresses a basic impediment to quality and safety improvement; it is an implementable model for integrating quality programs; it offers career-advancement potential for physicians interested in quality; it helps optimize investments in quality and safety; and it can be applied both within a single children's hospital and across multiple children's hospitals. Widespread adoption of the integration framework could have a transformative effect on the children's hospital sector, not the least of which is improved quality and safety on a large scale.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Levy FH,Brilli RJ,First LR,Hyman D,Kohrt AE,Ludwig S,Miles PV,Saffer Mdoi
10.1542/peds.2010-1409subject
Has Abstractpub_date
2011-06-01 00:00:00pages
1147-56issue
6eissn
0031-4005issn
1098-4275pii
peds.2010-1409journal_volume
127pub_type
杂志文章,评审相关文献
PEDIATRICS文献大全abstract:OBJECTIVE:Pacifier use has been reported to be associated with a reduced risk of sudden infant death syndrome (SIDS), but most countries around the world, including the United States, have been reluctant to recommend the use of pacifiers because of concerns about possible adverse effects. This meta-analysis was underta...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析
doi:10.1542/peds.2004-2631
更新日期:2005-11-01 00:00:00
abstract::This report describes an 8-year-old child with acute anthracycline-induced cardiomyopathy triggered by human herpesvirus 6 and the subsequent implantation of an intracorporeal continuous-flow left ventricular assist device (LVAD) and the process to discharge the child from the hospital. After barely 3 months on mechan...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-2272
更新日期:2014-09-01 00:00:00
abstract::Congenital fibrosarcoma (CFS) is a rare fibrous tissue malignancy that usually presents in the first few years of life. It is unique among human sarcomas in that it has an excellent prognosis. We describe a temporal clustering of a number of cases of CFS and investigate the possible associated prenatal risk factors. T...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-1307
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To assess whether the adequate antibody response observed in former extremely premature infants after the primary series of immunizations is sustained after the first booster vaccines. SUBJECTS AND METHODS:Sixteen former extremely premature (<29 weeks, <1000 g at birth) and 17 former full-term (>37 weeks) in...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.101.4.597
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:To describe the epidemiology of foreign-body ingestions (FBIs) of children <6 years of age who were treated in US emergency departments from 1995 to 2015. METHODS:We performed a retrospective analysis using data from the National Electronic Injury Surveillance System for children <6 years of age who were tr...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-1988
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Several observational studies have revealed that children who receive nonparental childcare are at increased risk of obesity. However, this may be due to unmeasured confounding or selection into different types of childcare. It is not well established whether this association reflects a causal...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-1539
更新日期:2016-11-01 00:00:00
abstract::This statement updates the 1994 American Academy of Pediatrics policy statement on baseball and softball injuries in children. Current studies on acute, overuse, and catastrophic injuries are reviewed with emphasis on the causes and mechanisms of injury. This information serves as a basis for recommending safe trainin...
journal_title:Pediatrics
pub_type: 指南,杂志文章
doi:10.1542/peds.107.4.782
更新日期:2001-04-01 00:00:00
abstract::Children who have suffered early abuse or neglect may later present with significant health and behavior problems that may persist long after the abusive or neglectful environment has been remediated. Neurobiological research suggests that early maltreatment may result in an altered psychological and physiologic respo...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2017-0100
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:The long-acting beta2-adrenergic agonist salmeterol prevents exercise-induced asthma, but tolerance may develop to its bronchoprotective effect. We wanted to ascertain if the development of tolerance could be prevented by using a low-dose treatment regimen of 50 microg once daily, instead of the usual dose o...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1542/peds.99.5.655
更新日期:1997-05-01 00:00:00
abstract::Henoch-Schonlein purpura is a multisystem vasculitis that primarily affects children. Characteristic symptoms include purpura of the lower extremities and buttocks, abdominal pain, arthralgias, and hematuria. Gastrointestinal bleeding occurs in approximately 50% of children and, although often self-limiting, can be si...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-3111
更新日期:2006-09-01 00:00:00
abstract::Next-generation sequencing has revolutionized the diagnostic process, making broadscale testing affordable and applicable to almost all specialties; however, there remain several challenges in its widespread implementation. Barriers such as lack of infrastructure or expertise within local health systems and complex re...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-0855
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate previous teacher reports that children exposed to cocaine prenatally have more problem behaviors. METHODS:A historical, prospective design was used. Maternal subjects (n = 116) of 6-year-old singleton, term (>/=36 weeks) children, and the children's first-grade teachers ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.102.4.945
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Severe breath-holding spells (BHS) in children consist of a stereotypical sequence of provocation to cry, noiseless expiration, color change, and loss of consciousness. Parenting a child who exhibits BHS is likely more stressful than parenting a healthy child, owing to this additional medical concern. It is ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.106.1.1
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:Although adverse health outcomes are increased among children with BMI above the 85th (overweight) and 95th (obese) percentiles, previous studies have not clearly defined the BMI percentile at which adverse health outcomes begin to increase. We examined whether the existing BMI percentile cutoffs are optimal ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-0179
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the economic impact of the 2009 routine US childhood immunization schedule, including diphtheria and tetanus toxoids and acellular pertussis, Haemophilus influenzae type b conjugate, inactivated poliovirus, measles/mumps/rubella, hepatitis B, varicella, 7-valent pneumococcal conjugate, hepatitis ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-0698
更新日期:2014-04-01 00:00:00
abstract::A previously healthy 15-year-old boy presented with 3 months of progressive psychosis, insomnia, back and groin pain, and hyperhidrosis. On examination, the patient was disheveled, agitated, and soaked with sweat, with systolic blood pressure in the 160s and heart rate in the 130s. Aside from occasional auditory and v...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-3786
更新日期:2020-06-01 00:00:00
abstract::Laparoscopy has been performed in 120 infants and children for a variety of indications including chronic abdominal pain, debatable appendicitis, liver biopsy, biliary atresia, and abdominal trauma. A specific diagnosis was made in 71% of patients and 59% were spared laparotomy. There were one complication and four er...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiologic, clinical, neuroimaging, and laboratory features; treatment; and outcome in a cohort of children with acute disseminated encephalomyelitis (ADEM). METHODS:A 6-year retrospective chart review of children with the diagnosis of ADEM was conducted. RESULTS:Eighteen cases were ident...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.110.2.e21
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine alterations in end-of-life support in a multiinstitutional sample of PICUs. METHODS:This was a retrospective, descriptive study. Variables collected included end-of-life support category, race, length of stay, operative status, reason for admission, and Pediatric Index of Mortality...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2010-0420
更新日期:2010-10-01 00:00:00
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:OBJECTIVES:Adenosine infusion causes selective pulmonary vasodilation in fetal and neonatal lambs with pulmonary hypertension. We investigated the effects of a continuous infusion of adenosine on oxygenation in term infants with persistent pulmonary hypertension of newborn (PPHN). DESIGN:A randomized, placebo-controll...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1996-03-01 00:00:00
abstract::A growing body of scientific literature demonstrates that children who grow up with 1 or 2 gay and/or lesbian parents fare as well in emotional, cognitive, social, and sexual functioning as do children whose parents are heterosexual. Children's optimal development seems to be influenced more by the nature of the relat...
journal_title:Pediatrics
pub_type:
doi:10.1542/peds.109.2.341
更新日期:2002-02-01 00:00:00
abstract::Primary type V hyperlipoproteinemia was identified in two preadolescent children. The propositus (kindred N) was a 10-year-old girl with severely creamy plasma, lipemia retinalis, hypertriglyceridemia (triglyceridelevel, 6,800 mg/100 ml), and ypercholesterolemia (cholesterol level, 490 mg/100 ml). Her parents and an 8...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1977-04-01 00:00:00
abstract::The effects of a single dose of surfactant TA were assessed in premature neonates (birth weight 750 to 1749 g) with respiratory distress syndrome (RDS) in a multicenter, double-blind, randomized clinical trial. Only neonates with surfactant deficiency and without ultrasonographic evidence of intracranial hemorrhage gr...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To investigate whether single-nucleotide polymorphisms in the promoter regions of endotoxin-responsive genes CD14 and tumor necrosis factor-alpha (TNF-alpha) are associated with biliary atresia (BA) and idiopathic neonatal cholestasis (INC). METHODS:We obtained genomic DNA from 90 patients with established d...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-1900
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To determine whether episodes of prolonged hypoxemia occur without prolonged apneic pauses (> or = 20 seconds) and without bradycardia (pulse rate, < or = 100 beats per minute) in apparently well preterm infants. METHODS:Long-term recordings of arterial oxygen saturation as measured by pulse oximetry (SpO2),...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract::Central nervous system manifestations in association with adenovirus infections have rarely been documented. In this report, four children, ages 4, 5, 6, and 10 years, with adenoviral meningoencephalitis are described. Adenoviruses were recovered from CSF specimens in all four patients. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:International efforts have been focused on identifying children at low risk of clinically important traumatic brain injury in whom computed tomography (CT) neuroimaging can be avoided. We sought to determine if CT use for pediatric head trauma has decreased among US emergency departments (EDs)...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-0814
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:End-of-life clinical care in cystic fibrosis (CF) differs substantially from terminal care in childhood cancer. To examine this difference, we reviewed the medical care of a cohort of CF patients treated at Children's Hospital, Boston, to document the use of preventive, therapeutic, and palliative care in the...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.100.2.205
更新日期:1997-08-01 00:00:00
abstract::This article provides an overview of neonatal intensive care unit treatment costs for hospitals that participated in the Neonatal Intensive Care Quality Improvement Collaborative Year 2000 (NIC/Q 2000) quality improvement collaborative and discusses how economic information can be used in quality improvement efforts. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:2003-04-01 00:00:00