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Ambulatory Quality, Special Health Care Needs, and Emergency Department or Hospital Use for US Children

Ambulatory Quality, Special Health Care Needs, and Emergency Department or Hospital Use for US Children

Hospital and emergency department (ED) visits are measures of health and chronic disease control. Reducing hospital and ED use is a family‐centered goal and can lower health care spending. However, a key unknown is whether and how ambulatory care quality predicts ED and hospital utilization in children by underlying chronic illness. HIP Investigator, Dr. Ryan Coller et al. sought to identify associations between parent‐reported ambulatory care quality and pediatric ED or hospital visits and evaluated how these relationships vary among children with different levels of medical complexity.

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Stumbling Into Adulthood: Learning From Depression While Growing Up

Stumbling Into Adulthood: Learning From Depression While Growing Up

In the United States, approximately 16% of adults aged 18 to 24 years report having been diagnosed with depression at some point in their lives. Growing attention to the specific impact of depression on people in their late teens and twenties corresponds with efforts in the behavioral and social sciences to more carefully delineate “emerging adulthood” either as a distinctive developmental phase, or simply as a protracted period between adolescence and adulthood created by contemporary social and economic conditions.

In this article, HIP Investigator Dr. Rachel Grob et al. examine how depression impacted respondent's transition from adolescence to emerging adulthood, and built their capacity to form a coherent identity and find a purpose in life.

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Growing Evidence for Successful Care Management in Children With Medical Complexity

Growing Evidence for Successful Care Management in Children With Medical Complexity

In this article, Dr. Mary Ehlenbach and HIP Investigator Dr. Ryan Coller reviewed the success of programs designed to better coordinate children with medical complexity care. With respect to changes in acute care use, children likely respond to complex care models in different ways. Additionally, what complex care achieves and how it achieves it for any given child is likely not uniform in cross section or over time.

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Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

The third edition of the Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy includes fundamental requirements to be followed when providing medical and other health care services using telecommunication technologies, and any other electronic communications between patients, practitioners, and other health care providers, as well as “best practice” recommendations. These guidelines were co-authored by HIP Investigator, Dr. Yao Liu and aim to assist providers in pursuing a sound course of action in providing safe and effective medical care using telehealth tools based on current scientific knowledge, technological requirements, and patient needs.

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Health System Research Priorities for Children and Youth With Special Health Care Needs

Health System Research Priorities for Children and Youth With Special Health Care Needs

Children and youth with special health care needs (CYSHCN) have, or are at an increased risk for, chronic physical, developmental, behavioral, or emotional conditions and also require health and related services of a type or amount beyond that required by children generally.

HIP Investigator, Dr. Ryan Coller et al. synthesized the opinions of a national multidisciplinary group of CYSHCN experts, including family caregivers, to prioritize research topics facing CYSHCN. Authors sought to take a foundational step toward developing a national research agenda for CYSHCN systems of care.

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Factors associated with health psychology use in pediatric type 1 diabetes

Factors associated with health psychology use in pediatric type 1 diabetes

For children with type 1 diabetes (T1D), self-management is complex and requires coordination between a child and his or her family multiple times every day to test blood sugars, determine and administer insulin doses, and adjust as needed. The consequences of suboptimal self-management are a combination of short- and long-term complications, some of which are life-threatening.

In this publication, HIP Investigator Dr. Elizabeth Cox et al. evaluated the prevalence of health psychology use in children with T1D and the association of this use with individual and contextual characteristics.

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Impact of family‐centered tailoring of pediatric diabetes self‐management resources

Impact of family‐centered tailoring of pediatric diabetes self‐management resources

Behavioral interventions to improve self‐management, glycemic control, or quality of life (QOL) for children with type 1 diabetes have small to moderate positive effects, but a host of challenges diminishes their effectiveness in practice. A group of authors including HIP Investigator, Dr. Elizabeth Cox evaluated the hypothesis that delivering self‐management resources in a family‐centered manner, using PRISM to guide resource selection, will result in better glycemic control and quality of life for children and their parents.

Authors found that tailored self‐management resources may improve outcomes among specific populations, suggesting the need to consider families' self‐management barriers and patient characteristics before implementing self‐management resources.

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Earlier Hospital Discharge With Prospectively Designated Discharge Time in the Electronic Health Record

Earlier Hospital Discharge With Prospectively Designated Discharge Time in the Electronic Health Record

Hospital discharge requires multidisciplinary coordination. Insufficient coordination impacts patient flow, resource use, and postdischarge outcomes. A team of authors including HIP Investigator, Dr. Ryan Coller implemented a prospective, multidisciplinary discharge timing designation in the electronic health record (EHR) and evaluated its association with discharge timing.

The group found that the implementation of a prospective, multidisciplinary EHR discharge time designation was associated with more before-noon discharges. Next steps include replicating results in other settings and determining populations that are most responsive to discharge coordination efforts.

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Investigating lupus retention in care to inform interventions for disparities reduction: an observational cohort study

Investigating lupus retention in care to inform interventions for disparities reduction: an observational cohort study

Systemic lupus erythematosus (SLE) is an autoimmune disease that disproportionately impacts young women, patients of color, and the socioeconomically disadvantaged, making SLE an important target for health disparity measurement and research. HIP Investigator, Dr. Christie Bartels et al. applied WHO-endorsed metrics that helped reduce similar disparities in HIV to investigate relationships between race, disadvantage, and retention in care in an urban lupus cohort. The authors examined predictors of lupus retention in care, developed an SLE Care Continuum, and informed interventions to reduce disparities. Key findings include 40% of patients not being retained at one year, and neighborhood disadvantage was the leading predictor of retention gaps.

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FCR

System Factors Influencing the Use of a Family-Centered Rounds Checklist

System Factors Influencing the Use of a Family-Centered Rounds Checklist

Checklists are used to operationalize care processes and enhance patient safety; however, checklist implementation is difficult within complex health systems. A family-centered rounds (FCR) checklist increased physician performance of key rounding activities, which were associated with improved parent engagement, safety perceptions, and behaviors. To inform FCR checklist implementation and dissemination, a team of authors including HIP Investigator, Dr. Elizabeth Cox assessed physician compliance with this checklist and factors influencing its use.

Authors found that multiple factors within hospital systems may influence FCR checklist use. Strategies, such as providing rounding schedules and mobile computers, may promote optimal engagement of families during rounds and promote pediatric patient safety.

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