Waste not, want not: Leading the lean health-care journey at Seattle Children's Hospital

2011 ◽  
Vol 30 (3) ◽  
pp. 25-31 ◽  
Author(s):  
Pat Hagan
Keyword(s):  
Health Care ◽  
Children's Hospital ◽  
Children’S Hospital

scholarly journals A113 COST SAVINGS OF SEROLOGIC VERSUS BIOPSY PROVEN DIAGNOSIS OF PEDIATRIC CELIAC DISEASE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 131-132
Author(s):  
M Wiepjes ◽  
H Q Huynh ◽  
J Wu ◽  
M Chen ◽  
L Shirton ◽  
...  
Keyword(s):  
Health Care ◽  
Celiac Disease ◽  
North America ◽  
Cost Saving ◽  
Health Care System ◽  
Cost Savings ◽  
Serologic Diagnosis ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Care System

Abstract Background Celiac disease (CD) affects approximately one percent of the population in Canada and the United States. At present, endoscopic diagnosis (ED) of CD remains the gold standard in North America, despite mounting evidence and validated European guidelines for serologic diagnosis (SD). Within publicly funded healthcare systems there is pressure to ensure optimal resource utilization and cost efficiency, including for endoscopic services. At Stollery Children’s Hospital, Edmonton, Canada, we have adopted serologic diagnosis as routine practice since 2016. Aims The aim of this study is to estimate cost savings, i.e. hard dollar savings and capacity improvements, to the health care system as well as impacts on families in regard to reduced work days lost and missing child school days for SD versus ED. Initial cost saving data is presented. Methods Micro-costing methods were used to determine health care resource use in patients undergoing ED or SD from 2017–2018. SD testing included anti-tissue glutaminase antibody (aTTG) ≥200IU/mL (on two occasions), human leukocyte antigen (HLA) DQA5/DQ2, blood sampling, transport and laboratory costs. ED diagnosis included gastroenterologist, anesthetist, OR equipment, staff, overhead and histopathology. Cost of each unit of resource was obtained from the schedule of medical benefits (Alberta) and reported average ambulatory cost for day hospital endoscopy for Stollery Children’s Hospital determined in 2016; reported in CAN$. Results Between March 2017-December 2018, 473 patients were referred for diagnosis of CD; 233 had ED and 127 SD. Estimated cost for ED was $1240 per patient; for SD was $85 per patient (6.8% of ED cost). Based on 127 patients not requiring endoscopy and a cost saving of $1155 per patient there was a total cost savings of $146,685 over 22 months. Conclusions A SD approach presents a significant cost savings to the public health care system. It also frees up valuable endoscopic resources, and limits exposure of children to the immediate and long-term risks associated with anesthesia and biopsy. SD also decreases time to diagnosis and the cost of the process to families (lost days of school/work, travel costs etc.). Our costing data can be used in combination with mounting evidence on the test performance of SD versus ED to determine cost-effectiveness of serological diagnosis for pediatric CD. Given the potential for cost saving and more efficient operating room utilization, SD for pediatric CD warrants further investigation in North America. Funding Agencies None

scholarly journals Modern approaches to improving the quality of medical care for premature children in Moscow health care

2020 ◽  
Vol 65 (1) ◽  
pp. 5-10 ◽  
Author(s):  
I. M. Osmanov ◽  
A. K. Mironova ◽  
A. L. Zaplatnikov
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Medical Care ◽  
Rehabilitation Center ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Quality Of Medical Care ◽  
Premature Children

This article is devoted to the issue of nursing and further monitoring of children born with very low and extremely low body weight. The article presents the data of international statistics and seven-year experience of the Rehabilitation Center for children born with very low and extremely low body weight, based on a large multidisciplinary children’s hospital. The authors pay particular attention to improvement of medical care of children born with very low and extremely low body weight.

scholarly journals Trends in Nosocomial Bloodstream Infections following Health Care Restructuring in Alberta between 1999 and 2005

2010 ◽  
Vol 21 (1) ◽  
pp. e1-e5 ◽  
Author(s):  
Mao-Cheng Lee ◽  
Lynora Saxinger ◽  
Sarah E Forgie ◽  
Geoffrey Taylor
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Alberta Hospital ◽  
University Of Alberta ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The University

OBJECTIVE: A previous study at the University of Alberta Hospital/Stollery Children’s Hospital in Edmonton, Alberta, revealed an increase in hospital-acquired bloodstream infection (BSI) rates associated with an increase in patient acuity during a period of public health care delivery restructuring between 1993 and 1996. The present study assessed trends in BSIs since the end of the restructuring.DESIGN: Prospective surveillance for BSIs was performed using Centers for Disease Control and Prevention (USA) criteria for infection. BSI cases between January 1, 1999, and December 31, 2005, were reviewed. Available measures of patient volumes, acuity and BSI risk factors between 1999 and 2005 were also reviewed from hospital records.SETTING: The University of Alberta Hospital/Stollery Children’s Hospital (617 adult and 139 pediatric beds, respectively).PATIENTS: All pediatric and adult patients admitted during the above-specified period with one or more episodes of BSIs.RESULTS: There was a significant overall decline in the BSI number and rate over the study period between 1999 and 2005. The downward trend was widespread, involving both adult and pediatric populations, as well as primary and secondary BSIs. During this period, the number of hospital-wide and intensive care unit admissions, intensive care unit central venous catheter-days, total parenteral nutrition days and number of solid-organ transplants were either unchanged or increased. Gram-positive bacterial causes of BSIs showed significant downward trends, but Gram-negative bacterial and fungal etiologies were unchanged.CONCLUSIONS: These data imply that, over time, hospitals can gradually adjust to changing patient care circumstances and, in this example, control infectious complications of health care delivery.

Who Should Provide Primary Health Care to Children: Pediatricians or Family Medicine Physicians?

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 460-477 ◽  
Author(s):  
Robert A. Hoekelman ◽  
Michael Klein ◽  
James E. Strain
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Albert Einstein ◽  
Assistant Professor ◽  
Senior Resident ◽  
Children's Hospital ◽  
Practice Experience ◽  
Primary Health ◽  
Children’S Hospital

INTRODUCTION —Robert A. Hoekelman, MD This debate is one of a series entitled "Controversies in Child Health and Pediatric Practice." In 1978 and 1979, the Department of Pediatrics at the University of Rochester conducted 12 such debates, which were published in book form in 1981.1 It is interesting that of these 12 controversies, not one has been resolved. That may prove to be the case for the controversy presented in this debate, "Who should provide primary health care to children: pediatricians or family medicine physicians?" Our guest speakers are Dr Michael Klein and Dr James E. Strain. Dr Klein is Professor of Family Medicine and Assistant Professor of Pediatrics at McGill University School of Medicine. He is also Director of the Department of Family Medicine and of the Herzl Family Practice Center at the Sir Mortimer B. Davis Jewish General Hospital in Montreal. Dr Klein received his medical degree at Stanford University in 1966, and he was his class's recipient of the pediatric Harold K. Kaiser Award. Dr Klein served his internship at Bronx Municipal Hospital Center at Albert Einstein University and his pediatric residency at Montreal Children's Hospital. During his last year, he served as Senior Resident in Neonatology under Robert Usher at the Royal Victoria Hospital. He then became a fellow in biochemical genetics under Charles Scriver and the Chief Medical Resident at Montreal Children's Hospital under Mary Ellen Avery. In 1970, he came to Rochester as a Fellow in Ambulatory Pediatrics. Dr Klein's practice experience is extensive. He was the pediatric coordinator of the St Jacques Clinic in Montreal during the late 1960s and the medical director of the Westside Health Services in Rochester from 1971 to 1975, after which he assumed his current position.

Neonatal Hospice Program

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 502-503
Author(s):  
Jonathan M. Whitfield ◽  
Anita Glicken ◽  
Robert Harmon ◽  
Roberta Siegel ◽  
L. Joseph Butterfield
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Health Care Professionals ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Staff Members ◽  
Children's Hospital ◽  
Children’S Hospital

We wish to comment on the editorial by Silverman (A hospice setting for humane neonatal death, Pediatrics 69:239, 1982), which we find both insightful and timely. We feel we must take issue with some of Silverman's statements. Over the last 3½ years we have actively incorporated hospice concepts into our neonatal program at Denver Children's Hospital, creating a so-called Neonatal Hospice Program. 1. We agree that health care professionals involved in neonatal intensive care tend to be oriented to "rescue" care; however, in our own experience we have found that with adequate training not only are the staff members open, but often they are very willing to switch from a rescue to palliative mode of treatment in the appropriate circumstances.

Incompetent Decisionmakers and Withdrawal of Life-Sustaining Treatment: A Case Study

2005 ◽  
Vol 33 (4) ◽  
pp. 851-856 ◽  
Author(s):  
Lance Lightfoot
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Team ◽  
Care Team ◽  
Children's Hospital ◽  
Institutional Ethics ◽  
Ethics Policies ◽  
Children’S Hospital ◽  
Life Sustaining Treatment

One of the most challenging and rewarding roles for in-house hospital attorneys is serving as a member of their hospital’s Bioethics Committee (the “Committee”). As a member of the Committee, an attorney assists in developing institutional ethics policies and guidelines, and also participates in ethics consultations involving disputes about patient care. Institutions such as the Author’s employer, Texas Children’s Hospital, promote open and honest communications between members of a patient’s health care team and the patient’s parents and family; however, when communications break down, the Committee’s goal is to provide an objective forum where disputes can be discussed and hopefully resolved in a professional, ethical manner.

scholarly journals Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy

2021 ◽  
Vol 13 (1) ◽  
pp. 118-124
Author(s):  
Désirée Caselli ◽  
Daniela Loconsole ◽  
Rita Dario ◽  
Maria Chironna ◽  
Maurizio Aricò
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Southern Italy ◽  
Hospital Setting ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Children's Hospital ◽  
Care Workers ◽  
Children’S Hospital ◽  
Second Wave

The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to assess the prevalence of SARS-CoV-2 infection in HCW in a third-level children’s hospital in Southern Italy. An observational cohort study of all asymptomatic HCW (physician, technicians, nurses, and logistic and support operators) was conducted. HCW were screened, on a voluntary basis, for SARS-CoV-2 by RT-PCR on nasopharyngeal swab performed during the first wave of COVID-19. The study was then repeated, with the same modalities, at a 7-month interval, during the “second wave” of the COVID-19 pandemic. At the initial screening between 7 and 24 April 2020, 525 HCW were tested. None of them tested positive. At the repeated screening, conducted between 9 and 20 November 2020, 627 HCW were tested, including 61 additional ones resulting from COVID-emergency recruitment. At this second screening, eight subjects (1.3%) tested positive, thus being diagnosed as asymptomatic carriers of SARS-CoV-2. They were one physician, five nurses, and two HCW from the logistic/support services. They were employed in eight different wards/services. In all cases, the epidemiological investigation showed convincing evidence that the infection was acquired through social contacts. The study revealed a very low circulation of SARS-CoV-2 infection in HCW tested with RT-PCR. All the infections documented in the second wave of epidemic of SARS-CoV-2 were acquired outside of the workplace, confirming that in a pediatric hospital setting, HCW education, correct use of personal protective equipment, and separation of the COVID-patient pathway and staff flow may minimize the risk derived from occupational exposure.

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