Obstetrics-gynecology Psychiatry Most rotations take place in the hospital, but some are community-based. Through these rotations, you are afforded the opportunity to develop procedural and cognitive skills, to practice your patient interaction skills, and to explore many aspects of medicine. These experiences will ultimately serve as your main point of reference for specialty choice.
Susan Lacey;1 Janis B. Our intent is to inform the reader about efforts underway by pediatric stakeholders and specialty groups and to understand where credible information can be accessed pertaining to patient safety and quality in the provision of care for the hospitalized child.
Over the past several years, pediatric groups have partnered to improve general understanding, reporting, process improvement methodologies, and quality of pediatric inpatient care. These collaborations have created a robust program of projects, benchmarking efforts, and research.
This chapter discusses general findings about safety and quality; major initiatives by agencies, groups, and collaborations; a guide to synthesis documents surrounding quality care and evidence-based practice for specific areas of pediatric care; and recommendations about how we can move pediatric safety and quality forward in practice and in the policy arena.
Patient safety literature and associated findings on adverse events for pediatric patients have been widely disseminated. Indeed, the Institute of Medicine IOM reported that medication errors are the most common, yet preventable, type of harm that can occur within the pediatric population, 10 and Bates 11 reported that when pediatric medication errors occur, these patients have a higher rate of death associated with the error than adult patients.
Medication errors, however, are only one potential adverse event for hospitalized children. Slonim and colleagues 4 found 1.
Four distinct challenges confront those conducting research and caring for children. Following are the four issues for pediatric patients, summarized from Beal and colleagues: As children mature both cognitively and physically, their needs as consumers of health care goods and services change.
Therefore, planning a unified approach to pediatric safety and quality is affected by the fluid nature of childhood development. Even when children can accurately express their needs, they are unlikely to receive the same acknowledgment accorded adult patients. In addition, because children are dependent on their caregivers, their care must be approved by parents or surrogates during all encounters.
Most hospitalized children require acute episodic care, not care for chronic conditions as with adult patients. Children are more likely than other groups to live in poverty and experience racial and ethnic disparities in health care. All quality research is challenged to standardize frameworks and language under which all care providers operate.
Each population has unique language and focused areas with no current common language across all specialty areas.
Pediatric safety and quality efforts are further challenged as most of the work on patient safety to date has focused on adult patients. There is no standard nomenclature for pediatric patient safety that is widely used.
However, a standard framework for classifying pediatric adverse events that offers flexibility has been introduced. Figure 1 Conceptual Model of a Patient Safety Taxonomy Standardization provides consistency between interdisciplinary teams and can facilitate multisite studies.
If these large-scale studies are conducted, the findings could generate large-scale intervention studies conducted with a faster life cycle. More rapid acceptance of efficacious improvement strategies should result. AHRQ has been a leader in funding safety and quality improvement efforts, synthesizing and disseminating findings to clinicians and the public for more than two decades to stimulate both scientific and policy dialogue.
AHRQ has been a leader in pediatric quality and safety.
A focus of AHRQ funding is translational research, which moves scientific findings to health care settings across the care continuum. Projects funded by AHRQ help determine where gaps in safety and quality exist.
HCUP is the largest information source of patient encounters in both inpatient and outpatient settings. All HCUP databases contain more than variables linked to patient care, including both clinical and charge data.
The HCUP databases are used by clinicians and health services researchers to investigate care delivery and discover trends in outcomes and costs.
They are also used internally at AHRQ for special projects, such as the development of pediatric indicators outlined in the next section. They found that hospitalized children who experienced a patient safety incident, compared with those who did not, had Length of stay 2- to 6-fold longer Hospital mortality 2- to fold greater Hospital charges 2- to fold higher Another key finding in this initial work demonstrated that severity of illness and type of hospital are directly associated with patient safety incidents, except for birth trauma.
Birth trauma was directly associated with African American and Hispanic race, but not type of hospital.Mar 28, · Background. Challenges in implementing electronic health records (EHRs) have received some attention, but less is known about the process of transitioning from legacy EHRs to newer systems.
Medical school can be challenging for anyone, with high demands on time, the pressures of managing an ever-growing body of information, and the need to constantly juggle multiple responsibilities.
Emergency nursing is demanding because of the diversity of conditions and situations that present unique challenges Academic Degree and Emergency Room Nurse Essay used as primary care by local residents • ED transfers to clinical units taking more than 15 hours • Patients lying on stretchers for long periods of.
In overcoming the challenges she faced over the next several years, she came to understand that parents need shared knowledge, access to resources and services, and strong community bonds.
the committee will examine research across diverse populations of families and identify the unique strengths/assets of traditionally underrepresented.
Persistent challenges in providing care to seriously ill pediatric patients continue, despite evidence-based approaches to treatment decision-making, the emergence of pediatric palliative care as an interdisciplinary subspecialty, and the growing number of children’s hospitals. Five Ethical Challenges in Healthcare.
By Susan Kreimer, MS, contributor. July 7, - Providing good patient care and avoiding harm are the cornerstones of ethical practice. Healthcare workers want to do the right thing, but it isn’t always clear how they should proceed.