scholarly journals The Utility of Interaction Design as a Novel Tool to Improve Hand Hygiene Frequency on a Pediatric Hematology-Oncology Ward

2020 ◽  
Vol 41 (S1) ◽  
pp. s411-s411
Author(s):  
Johanna Blaak ◽  
Rachel DiMaio ◽  
Julia Kupis ◽  
Ross Sweetzir ◽  
Conny Betuzzi ◽  
...  
Keyword(s):  
Health Services ◽  
Hand Hygiene ◽  
Interaction Design ◽  
Qualitative Interviews ◽  
Cell Transplant ◽  
Children's Hospital ◽  
University Of Calgary ◽  
Children’S Hospital ◽  
The Mean ◽  
Alberta Health

Johanna Blaak, W21C, University of Calgary; Rachel DiMaio, University of Calgary; Julia Kupis, University of Calgary; Ross Sweetzir, Cisco Systems; Conny Betuzzi, Alberta Children’s Hospital, Alberta Health Services; Corey Dowler, Alberta Children’s Hospital, Alberta Health Services; Krista McIntytre, Alberta Children’s Hospital, Alberta Health Services; Jaime Kaufman, University of Calgary; Greg Hallihan, University of Calgary; John Conly, Foothills Medical Centre; Joseph Vayalumkal, Alberta Childrens HospitalBackground: Interaction design offers a novel interventional strategy to enhance hand-hygiene compliance (HHC) and reduce hospital-acquired infections (HAIs) in the pediatric setting. A quality improvement initiative in collaboration with the University of Calgary and Alberta Health Services led to the implementation of a pilot project with sensor-embedded alcohol -based hand rub (ABHR) dispensers at a hematology-oncology and hematopoietic stem cell transplant unit at Alberta Children’s Hospital (ACH). Methods: Internet of things (IoT) sensors were installed in ABHR dispensers (n = 3) on the unit. Usage data were transmitted to a local server using an MQTT messaging protocol for 16 weeks. Real-time data visualization was presented on a central display next to the nursing station with 11 unique pediatric themes including dinosaurs, transportation, and Canadian animals. Data were collected with and without visualization, and frequency of use (FoU) was determined for both periods. Qualitative interviews with unit stakeholders (n = 13) were held to determine perceptions of the intervention. Results: During the first 8 weeks of the study period, the mean daily use without visualization was 47 times (SD, 14.5) versus 99 times (SD, 23.9) with visualization. When accounting for novelty, by removing the first week of data, the mean daily use was 92 (SD 19.6). The percentage increase from period 1 to period 2 was 96.6%, accounting for novelty. Qualitative interviews with stakeholders (n = 13) on the unit indicated that the intervention increased their personal awareness of hand hygiene (75%) and acted as a constant reminder to perform hand hygiene for everyone on the unit including nonclinical staff, patients, and family members (92%). Conclusions: These limited data suggest that interaction design may improve HH frequency and show promise as a tool for increased HH awareness and education. Interaction design provides a unique, innovative, and acceptable hand hygiene improvement strategy for staff, patients, and families in the pediatric inpatient setting.Funding: NoneDisclosures: None

scholarly journals Evaluation of quality of care for patients with congenital heart disease using ECHSA Congenital Database integrated tools

2021 ◽  
Vol 25 (1) ◽  
pp. 52
Author(s):  
O. Yu. Kornoukhov ◽  
A. A. Karimov ◽  
V. N. Ilyin
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Mortality ◽  
Conflict Of Interest ◽  
Congenital Heart ◽  
Z Score ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Mean

<p><strong>Background.</strong> A quality of surgical care evaluation based solely on workload and hospital mortality is incomplete. ECHSA Congenital Database integrated tools provide complexity-adjusted methods to evaluate surgical results and the surgical performance of a hospital, and make it possible to demonstrate hospital service level among other congenital heart programmes.</p><p><strong>Methods.</strong> Data on 2,521 operations in a population of children, including 532 newborns, with congenital heart disease (CHD) were uploaded on the European Congenital Heart Surgeons Association Congenital Database. These data were collected between 2012 and 2018 at the Filatov Children's Hospital. We compared our personal results with database mean values according to the following criteria: 1) proportion of newborns among all paediatric surgical cases, 2) hospital mortality, 3) Aristotle Basic Score (ABS) value, 4) STS-EACTS Mortality Score (MtS) value, and 5) MtS Performance value. All data on the database website were analysed using integrated database tools.</p><p><strong>Results.</strong> The proportion of newborns in the Filatov Children's Hospital was 21.1%, while the database mean value was 18.6%, and hospital mortality values were 3.89% and 3.61%, respectively. The mean ABS in the Filatov Children's Hospital was 6.78 ± 2.08, while that on the database was 6.57 ± 2.12 (Z-score = 0.075). The mean MtS values for the hospital and database were 0.74 ± 0.59 and 0.72 ± 0.64, respectively (Z-score = 0.031). The calculated MtS performance for the Filatov Children's Hospital was 0.72 ± 0.56, while that for all European respondents was 0.54 ± 0.29 (Z-score = 0.603).</p><p><strong>Conclusion.</strong> Cooperation with a multicentre international database, such as ECHSA Congenital Database, provides modern complexity-adjusted tools for evaluation of quality of care for children with CHD. The Filatov Children’s Hospital is a high-volume cardiac surgery centre that demonstrates an adequate survival rate regarding complexity level and surgical risk compared to European respondents of the ECHSA Congenital Database.</p><p>Received 19 October 2020. Revised 18 November 2020. Accepted 19 November 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals Demographics and utilisation of health services by paediatric refugees from East Africa: implications for service planning and provision

2004 ◽  
Vol 27 (2) ◽  
pp. 40 ◽  
Author(s):  
Regina Cooke ◽  
Sally Murray ◽  
Jonathan Carapetis ◽  
James Rice ◽  
Nigisti Mulholland ◽  
...  
Keyword(s):  
Health Services ◽  
Immigrant Health ◽  
Clinical Epidemiology ◽  
Social Scientist ◽  
Service Planning ◽  
Health Clinic ◽  
Senior Lecturer ◽  
Children's Hospital ◽  
University Of British Columbia ◽  
Children’S Hospital

Regina Cooke is a Clinical Fellow at the Royal Children's Hospital, Melbourne. Sally Murray is an Honorary Fellow of the University of Melbourne and former Program Coordinator of the Victorian Immigrant Health Program, Department of Paediatrics, University of Melbourne. Jonathan Carapetis is an Infectious Diseases Physician, Royal Children's Hospital, Senior Lecturer, Department of Paediatrics,University of Melbourne and Research Fellow, Murdoch Children's Research Institute. James Rice is a Clinical Fellow at University of British Columbia, Canada and formerly of Royal Children's Hospital, Melbourne. Nigisti Mulholland is a Social Scientist, formerly of Royal Children's Hospital, Melbourne.Susan Skull is Deputy Director of the Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, and Senior Lecturer, Department of Paediatrics, University of Melbourne.Little is known of difficulties in accessing health care for recently arrived paediatric refugees in Australia. We reviewedroutinely collected data for all 199 East African children attending a hospital Immigrant Health Clinic for the first time over a 16 month period. Although 63% of parents reported medical consultations since arrival, 77% of this group reported outstanding, unaddressed health problems. Availability of interpreters and information on health services were the main factors hindering access to care. These data have informed future service planning at the Clinic.Ongoing data collection is key to maintaining a responsive, targeted service for a continually changing population.

scholarly journals Taking the next step in publication productivity analysis in pediatric neurosurgery

2018 ◽  
Vol 21 (6) ◽  
pp. 655-665 ◽  
Author(s):  
Ryan P. Lee ◽  
Raymond Xu ◽  
Pooja Dave ◽  
Sonia Ajmera ◽  
Jock C. Lillard ◽  
...  
Keyword(s):  
Basic Science ◽  
Pediatric Neurosurgery ◽  
Faculty Members ◽  
Children's Hospital ◽  
Tier 1 ◽  
Children’S Hospital ◽  
Fellowship Programs ◽  
The Mean ◽  
Tier 3 ◽  
Number Of Citations

OBJECTIVEThere has been an increasing interest in the quantitative analysis of publishing within the field of neurosurgery at the individual, group, and institutional levels. The authors present an updated analysis of accredited pediatric neurosurgery training programs.METHODSAll 28 Accreditation Council for Pediatric Neurosurgery Fellowship programs were contacted for the names of pediatric neurosurgeons who were present each year from 2011 through 2015. Faculty names were queried in Scopus for publications and citations during this time period. The 5-year institutional Hirsch index [ih(5)-index] and revised 5-year institutional h-index [ir(5)-index] were calculated to rank programs. Each publication was reviewed to determine authorship value, tier of research, clinical versus basic science research, subject matter, and whether it was pediatrics-specific. A unique 3-tier article classification system was introduced to stratify clinical articles by quality and complexity, with tier 3 being the lowest tier of publication (e.g., case reports) and tier 1 being the highest (e.g., randomized controlled trials).RESULTSAmong 2060 unique publications, 1378 (67%) were pediatrics-specific. The pediatrics-specific articles had a mean of 15.2 citations per publication (median 6), whereas the non–pediatrics-specific articles had a mean of 23.0 citations per publication (median 8; p < 0.0001). For the 46% of papers that had a pediatric neurosurgeon as first or last author, the mean number of citations per publication was 12.1 (median 5.0) compared with 22.5 (median 8.0) for those in which a pediatric neurosurgeon was a middle author (p < 0.0001). Seventy-nine percent of articles were clinical research and 21% were basic science or translational research; however, basic science and translational articles had a mean of 36.9 citations per publication (median 15) compared with 12.6 for clinical publications (median 5.0; p < 0.0001). Among clinical articles, tier 1 papers had a mean of 15.0 citations per publication (median 8.0), tier 2 papers had a mean of 18.7 (median 8.0), and tier 3 papers had a mean of 7.8 (median 3.0). Neuro-oncology papers received the highest number of citations per publication (mean 25.7). The most common journal was the Journal of Neurosurgery: Pediatrics (20%). MD/PhD faculty members had significantly more citations per publication than MD faculty members (mean 26.7 vs 14.0; p < 0.0001) and also a higher number of publications per author (mean 38.6 vs 20.8). The median ih(5)- and ir(5)-indices per program were 14 (range 5–48) and 10 (range 5.6–37.2), respectively. The mean ir(5)/ih(5)-index ratio was 0.8. The top 5 fellowship programs (in descending order) as ranked by the ih(5)-index corrected for number of faculty members were The Hospital for Sick Children, Toronto; Children’s Hospital of Pittsburgh; University of California, San Francisco Benioff Children’s Hospital; Seattle Children’s Hospital; and St. Louis Children’s Hospital.CONCLUSIONSAbout two-thirds of publications authored by pediatric neurosurgeons are pediatrics-specific, although non–pediatrics-specific articles averaged more citations. Most of the articles authored by pediatric neurosurgeons are clinical, with basic and translational articles averaging more citations. Neurosurgeons with PhD degrees averaged more total publications and more citations per publication. In all, this is the most advanced and informative analysis of publication productivity in pediatric neurosurgery to date.

Successful hand hygiene improvement strategy in a referral children’s hospital in Armenia

2010 ◽  
Vol 76 (4) ◽  
pp. 362-363 ◽  
Author(s):  
B. Bédat ◽  
F. Mauler ◽  
B. Allegranzi ◽  
M.-N. Chraïti ◽  
S. Touveneau ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improvement Strategy ◽  
Hand Hygiene Improvement ◽  
Children's Hospital ◽  
Children’S Hospital

Training pediatricians for primary medical care

PEDIATRICS ◽  
1974 ◽  
Vol 54 (2) ◽  
pp. 131-133
Author(s):  
Jack G. Shiller
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Medical Care ◽  
Research Training ◽  
Medical Center ◽  
Memorial Lecture ◽  
Recent Issue ◽  
Primary Medical Care ◽  
Children's Hospital ◽  
Children’S Hospital

A recent issue of this Journal carried the Kenneth G. Blackfan Memorial Lecture delivered to the Children's Hospital Alumni Association in Boston on May 30, 1973.1 It was given by Dr. Cicely Williams and entitled "Health Services in the Home." In her message directed at pediatric academia, Dr. Williams essentially said, "Be off with your ultrascience, your superspecialists ... Give thought instead to the thousands who are sick ... Teachers, stop seducing the very best into your snare of enzymes, isotopes and transducers, leaving only a small group to replace our dwindling cohort of primary care deliverers." That very same issue carried a commentary entitled "Primary Medical Care and Medical Research Training" by Dr. David G. Nathan of the Children's Hospital Medical Center.2

Fixation with C-2 laminar screws in occipitocervical or C1–2 constructs in children 5 years of age or younger: a series of 18 patients

2014 ◽  
Vol 14 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Jennifer G. Savage ◽  
Daniel H. Fulkerson ◽  
Anish N. Sen ◽  
Jonathan G. Thomas ◽  
Andrew Jea
Keyword(s):  
Cervical Spine ◽  
Screw Placement ◽  
Upper Cervical Spine ◽  
Children's Hospital ◽  
Translaminar Screw ◽  
Upper Cervical ◽  
Children’S Hospital ◽  
The Mean ◽  
Translaminar Screws

Object There are rare indications for upper cervical spine fusion in young children. Compared with nonrigid constructs, rigid instrumentation with screw fixation increases the fusion rate and reduces the need for halo fixation. Instrumentation may be technically challenging in younger children. A number of screw placement techniques have been described. Use of C-2 translaminar screws has been shown to be anatomically feasible, even in the youngest of children. However, there are few data detailing the clinical outcome. In this study, the authors describe the clinical and radiographic follow-up of 18 children 5 years of age or younger who had at least one C-2 translaminar screw as part of an occipitocervical or C1–2 fusion construct. Methods A retrospective review of all children treated with instrumented occipitocervical or C1–2 fusion between July 1, 2007, and June 30, 2013, at Riley Children's Hospital and Texas Children's Hospital was performed. All children 5 years of age or younger with incorporation of at least one C-2 translaminar screw were identified. Results Eighteen children were studied (7 boys and 11 girls). The mean age at surgery was 38.1 months (range 10–68 months). Indications for surgery included traumatic instability (6), os odontoideum (3), destructive processes (2), and congenital instability (7). A total of 24 C-2 translaminar screws were placed; 23 (95.8%) of 24 were satisfactorily placed (completely contained within the cortical walls). There was one medial cortex breach without neurological impingement. There were no complications with screw placement. Three patients required wound revisions. Two patients died as a result of their original condition (trauma, malignant tumor). The mean follow-up duration for the surviving patients was 17.5 months (range 3–60 months). Eleven (91.7%) of the 12 patients followed for 6 months or longer showed radiographic stability or completed fusion. Conclusions Use of C-2 translaminar screws provides an effective anchor for internal fixation of the upper cervical spine. In this study of children 5 years of age or younger, the authors found a high rate of radiographic fusion with a low rate of complications.

scholarly journals Improving ECG Services at a Children’s Hospital: Implementation of a Digital ECG System

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Frank A. Osei ◽  
Gregory J. Gates ◽  
Steven J. Choi ◽  
Daphne T. Hsu ◽  
Robert H. Pass ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Outpatient Service ◽  
Digital System ◽  
Quality Improvement Initiative ◽  
Fourfold Increase ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Mean ◽  
Significant Change

Background.The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children’s hospital.Methods.As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE) was implemented at the Children’s Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared viat-tests.Results.The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p<0.001), a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p<0.001).Conclusion.Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported.

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