scholarly journals Connecting Medical Personnel to Dentists via Teledentistry in a Children's Hospital System: A Pilot Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Kimberly J. Hammersmith ◽  
Macaire C. Thiel ◽  
Matthew J. Messina ◽  
Paul S. Casamassimo ◽  
Janice A. Townsend
Keyword(s):  
New Technology ◽  
Primary Care Clinic ◽  
Dental Trauma ◽  
Medical Personnel ◽  
Urgent Care ◽  
Hospital System ◽  
Care Clinic ◽  
Children's Hospital ◽  
System A ◽  
Children’S Hospital

Investigators evaluated feasibility, acceptability, and sustainability of a teledentistry pilot program within a children's hospital network between March, 2018, and April, 2019. The program connected dentists to medical personnel and patients being treated in urgent care clinics, a primary care clinic, and a freestanding emergency department via synchronous video consultation. Three separate but parallel questionnaires evaluated caregiver, medical personnel, and dentist perspectives on the experience. Utilization of teledentistry was very low (2%, 14/826 opportunities), but attitudes regarding this service were largely positive among all groups involved and across all survey domains. Uptake of new technology has barriers but teledentistry may be an acceptable service, especially in the case of dental trauma.

Use of Health Care Services by Inner-city Infants in an Early Discharge Program

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 686-691
Author(s):  
William O. Cooper ◽  
Uma R. Kotagal ◽  
Harry D. Atherton ◽  
Carrie A. Lippert ◽  
Elizabeth Bragg ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Inner City ◽  
Primary Care Clinic ◽  
Early Discharge ◽  
Emergency Department Visits ◽  
Care Clinic ◽  
Children's Hospital ◽  
Care Services ◽  
Children’S Hospital

Objective. To assess the use of health care services by inner-city infants enrolled in an early discharge program who received care in a tertiary care children's hospital primary care clinic. Design. Retrospective cohort study. Setting. Large, metropolitan university hospital and a children's hospital. Patients. Term infants cared for in a single full-term nursery, before and after implementation of a coordinated early discharge program, who received primary care at the children's hospital. Intervention. The coordinated Early Discharge Program was characterized by in-hospital visits by hospitalbased coordinating nurses, home visits by nurses from a home nursing agency, and communication with physicians for necessary adjustments in postdischarge care. Methods. After linking birth hospital records and the children's hospital medical records, a retrospective chart review was performed to obtain maternal demographic information and birth hospital length of stay, as well as the infants' attendance at primary care clinic, immunizations, emergency department visits, and rehospitalization. Main Outcome Measures. Number of primary care visits in the first 3 months of life, completion of one series of immunizations by 3 months of life, and number of emergency department visits and rehospitalization during the first 3 months of life. Results. The early discharge group (n = 253) had a significantly shorter birth hospital length of stay (35 ± 24 hours, mean ± SD) when compared with the control group (n = 212) (52 ± 14 hours). The early discharge group was also younger than the control group at the first primary care visit, with significantly more infants visiting the primary care clinic in the first month of life. There was also a significant difference between the groups in the mean number of emergency department visits (early discharge = .61 visits/patient, control = .79 visits/patient) and the proportion of patients with no emergency department visits during the first 3 months of life (early discharge = 57%, control = 43%). There was no difference between the two groups in the proportion of infants completing one series of immunizations or in the number of infants rehospitalized during the study period. Conclusions. Coordinated early discharge with home nursing visits for inner-city infants may result in earlier use of primary care services. Furthermore, there is a significant decrease in use of the emergency department during the first 3 months of life, and no increase in rehospitalization.

The impact of a complex care clinic in a children's hospital

2010 ◽  
Vol 36 (4) ◽  
pp. 574-582 ◽  
Author(s):  
E. Cohen ◽  
J. N. Friedman ◽  
S. Mahant ◽  
S. Adams ◽  
V. Jovcevska ◽  
...  
Keyword(s):  
Complex Care ◽  
Care Clinic ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Impact

scholarly journals Using Administrative Health Data to Define a Cohort of Youth Affected by Chronic Health Conditions: Preparing for Cross-Sectoral Data Linkage

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Kyleigh Schraeder ◽  
Olesya Barrett ◽  
Alberto Nettel-Aguirre ◽  
Gina Dimitropoulos ◽  
Andrew Mackie ◽  
...  
Keyword(s):  
Health Services ◽  
Transition To Adulthood ◽  
Chronic Care ◽  
Data Linkage ◽  
Tertiary Care ◽  
Data Repository ◽  
Area Deprivation ◽  
Care Clinic ◽  
Children's Hospital ◽  
Children’S Hospital

IntroductionIn Alberta, 2,400 youth with chronic needs transition to adulthood every year, and many are not prepared for this change. Transferring youth from pediatric to adult-oriented care is poorly managed. To improve this process, we need to know how youth patients use health services during this period. Objectives and ApproachWe used the Alberta Health Services Corporate Data Repository (CDR-9), which collects records of ambulatory visits, to define a cohort of patients with chronic disease using pediatric tertiary care; data is available from 2008 to 2016. Personal health numbers allowed for deterministic data linkage to CDR-9, registry data (e.g., death dates, moves out of province), and area deprivation indices. Eligible patients were: (a) between ages 12-15 years in 2008 (for ≥2 years observation in adulthood, after age 18), (b) involved with a Chronic Care Clinic (CCC) at Alberta Children’s Hospital, and (c) had repeated CCC visits with ≥3 months between visits. ResultsWe identified 26 Chronic Care Clinics (CCC) at Alberta Children’s Hospital (Calgary, Alberta), with stakeholder input. Using CDR-9, a total of 10,111 patients at the hospital were identified who were 12 to 15 years old at the start of the study window (in 2008), and who visited a CCC before age 18. Less than 1% (n=418) were excluded due to moving out of province or having an invalid personal heath number. Final sample sizes were captured across 3 algorithms (A1, A2, A3), based on frequency of CCC visits within a 2-year period: (i) A1: ≥2 CCC visits (N=4123); (ii) A2: ≥3 CCC visits (N=2242); (iii) A3: ≥4 CCC visits (N=1344). Conclusion/ImplicationsOur identified cohort of youth affected by chronic conditions is the first of its kind in Alberta, and can answer important questions about patterns of service utilization in other sectors of care. Our next step is to link the cohort to population-level datasets (e.g., physician claims, NACRS, CIHI-DAD).

New technology increases perioperative haemoglobin levels for paediatric cardiopulmonary bypass: what is the benefit?

Perfusion ◽  
2006 ◽  
Vol 21 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Clarke Thuys ◽  
Stephen Horton ◽  
Martin Bennett ◽  
Simon Augustin
Keyword(s):  
Cardiopulmonary Bypass ◽  
Haemoglobin Level ◽  
New Technology ◽  
Children's Hospital ◽  
Priming Volume ◽  
Children’S Hospital ◽  
Membrane Oxygenators

Increasing perioperative haemoglobin level by reducing priming volume and maintaining a safe cardiopulmonary bypass (CPB) system is the aim of every perfusionist. In this study, we have compared the two membrane oxygenators and pump systems used for paediatric bypass at the Royal Children’s Hospital on a regular basis since 1988. We looked at all patients who had the Cobe VPCML (Cobe Laboratories, Denver, CO, USA) and Terumo RX-05 (Terumo Corporation, Tokyo, Japan) oxygenators used for flows from 800 mL/min up to the maximum rated flow for the respective oxygenator from January 2002 until March 2004. The VPCML refers to using only the 0.4-m2 section of the oxygenator. The pump systems used were the Stöckert CAPS (Stöckert Instrumente GmbH, Munich, Germany) and Jostra HL 30 (Jostra AB, Lund, Sweden). Changing from the VPCML to the RX-05 resulted in a 37% reduction in priming volume. The introduction of the Jostra HL 30 with a custom-designed mast system reduced the priming volume by another 15%. This change in priming volume allowed a significant increase, from 6 to 34%, in the percentage of patients who received bloodless primes, and for those patients who received blood primes, an increase in haemoglobin (Hb) on bypass from 8.2 to 9.6 g/dL, on average.

Treating pediatric hydrocephalus in Australia: a 3-year hospital-based cost analysis and comparison with other studies

2013 ◽  
Vol 11 (4) ◽  
pp. 398-401 ◽  
Author(s):  
Alan Chuong Q. Pham ◽  
Christine Fan ◽  
Brian K. Owler
Keyword(s):  
Average Cost ◽  
Shunt Revision ◽  
Neurosurgical Procedures ◽  
Shunt Insertion ◽  
Hospital System ◽  
Children's Hospital ◽  
Pediatric Hydrocephalus ◽  
Children’S Hospital ◽  
Previously Treated ◽  
Cost Per Admission

Object The aim of this study was to quantify the financial costs of surgical intervention in patients with newly diagnosed hydrocephalus and patients with treatment failure or complications of previously treated hydrocephalus between 2007 and 2009 at the Children's Hospital at Westmead in Sydney, Australia. Methods This was a retrospective study of patients who underwent shunt insertion, shunt revision, treatment of an infected shunt, and endoscopic third ventriculostomy (ETV) between 2007 and 2009. Actual hospital costs associated with each inpatient stay were obtained from the accounting office of Children's Hospital at Westmead. Patients with hydrocephalus secondary to trauma, malignancy, or other complex conditions (except myelomeningocele) were excluded. Results Hydrocephalus-related procedures comprised approximately one-third of neurosurgical procedures performed each year. From 2007 to 2009, there were 192 admissions during which 300 procedures were performed for 162 patients. The total cost was $4.78 million (Australian) with an average cost of $1.59 million per year. The cost per admission for shunt insertion and ETV were similar ($13,905 vs $14,128, respectively). The average cost per admission for shunt revision was $9,753. However, shunt infection was associated with 40% of total costs, averaging $83,649 per admission. Management of patients with myelomeningocele undergoing insertion of shunt procedures in the same admission accounted for an average cost of $50,186. Conclusions Hydrocephalus is a chronic condition that imposes a significant and growing economic burden upon the Australian hospital system. Seventy-five percent of hydrocephalus-related hospital expenditure is used to surgically treat patients for complications or failure of previously treated hydrocephalus. Further research into the economic impact of pediatric hydrocephalus on the Australian health care system and concerted research efforts in the area of effective long-term surgical treatment and complication minimization are essential.

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