Doctor checking sugar level

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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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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Pregnant woman with doctor

Qualitative Research on Expanded Prenatal and Newborn Screening: Robust but Marginalized

Qualitative Research on Expanded Prenatal and Newborn Screening: Robust but Marginalized

Screening technologies are iteratively transforming how people experience pregnancy and early parenting. A new class of newborn patients are being created and that particular forms of parental vigilance were emerging. HIP Investigator Dr. Rachel Grob wrote extensive qualitative literature that documents all of these social phenomena, and more, in connection with the spread of prenatal and newborn screening.

This essay uses qualitative research on prenatal and newborn screening as a case study for illustrating the broad methodological, ideological, and dialogical issues at stake.

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Medical team meeting

What Are We Measuring? Evaluating Physician-Specific Satisfaction Scores Between Emergency Departments

What Are We Measuring? Evaluating Physician-Specific Satisfaction Scores Between Emergency Departments

Most emergency departments (ED) use patient experience surveys (i.e., Press Ganey) that include specific physician assessment fields. A team of authors including HIP Investigator, Dr. Brian Patterson determined whether Press Ganey ED satisfaction scores for emergency physicians working at two different sites were consistent between sites, and to identify factors contributing to any variation.

The group found that Press Ganey satisfaction scores for the same group of emergency physicians varied significantly between sites suggesting that these scores are more dependent on site-specific factors, such as wait times, than a true representation of the quality of care provided by the physician.

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Mother and daughter with staff

Evaluating Integrated Care for Children: A Clarion Call or a Call for Clarity?

Evaluating Integrated Care for Children: A Clarion Call or a Call for Clarity?

“Integrated care” is often used to describe concepts such as coordinated and seamless care instead of the often fragmented and episodic care that patients receive. Integrated care reflects the aspirations of modern health care systems and receives significant academic attention. Authors Dr. Eyal Cohen and HIP Investigator, Dr. Ryan Coller conducted a broad search strategy to identify randomized controlled trials comparing integrated care with usual care.

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Big Data Word Scramble

Evaluating care for high-need high-cost patients using the National Patient-Centered Clinical Research Network (PCORNet)

Evaluating care for high-need high-cost patients using the National Patient-Centered Clinical Research Network (PCORNet)

Case management programs for high-need high-cost patients are spreading rapidly among health systems. PCORNet has substantial potential to support learning health systems in rapidly evaluating these programs, but access to complete patient data on health care utilization is limited as PCORNet is based on electronic health records not health insurance claims data. Because matching cases to comparison patients on baseline utilization is often a critical component of high-quality observational comparative effectiveness research for high-need high-cost patients, limited access to claims may negatively affect the quality of the matching process. A team of authors including HIP Investigators Dr. Maureen Smith and Dr. Menggang Yu sought to determine whether the evaluation of programs for high-need high-cost patients required claims data to match cases to comparison patients.

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Pediatric exam at clinic

Reliability and validity of PROMIS® pediatric family relationships short form in children 8-17 years of age with chronic disease

Reliability and validity of PROMIS® pediatric family relationships short form in children 8-17 years of age with chronic disease

Families play a key role in managing pediatric chronic illness. The PROMIS® pediatric family relationships measure was developed primarily within the general pediatric population. HIP Investigator, Dr. Elizabeth Cox et al. evaluated the Family Relationships short form in the context of pediatric chronic diseases and presented their findings as to whether the Family Relationships measure demonstrates adequate reliability and validity when applied in a clinical population of chronically ill children and their parents.

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Child patient hospitalized

Variation in Hospitalization Rates Following Emergency Department Visits in Children with Medical Complexity

Variation in Hospitalization Rates Following Emergency Department Visits in Children with Medical Complexity

Children with medical complexity (CMC) have lifelong, complex chronic conditions (CCCs) associated with multimorbidity, severe functional limitations, myriad health care needs, and high resource use. Although hospitalizations have been a long-standing measure of a potentially avoidable CMC health service, little is known about the opportunity to influence the hospitalization risk from an ED visit. Therefore, HIP Investigator Dr. Ryan Coller et al. identified factors associated with admission within ED encounters and to quantified both the overall ED admission rate for CMC and admission rate variation across children's hospitals.

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Holding hands

Fused comparative intervention scoring for heterogeneity of longitudinal intervention effects

Fused comparative intervention scoring for heterogeneity of longitudinal intervention effects

With the growing cost of health care in the United States, the need to improve efficiency and efficacy has become increasingly urgent. There has been a keen interest in developing interventions to effectively coordinate the typically fragmented care of patients with many comorbidities. Evaluation of such interventions is often challenging given their long-term nature and their differential effectiveness among different patients. Furthermore, care coordination interventions are often highly resource-intensive. Hence there is pressing need to identify which patients would benefit the most from a care coordination program. In this work, Dr. Jared Huling and HIP Investigators Dr. Menggang Yu and Dr. Maureen Smith introduced a subgroup identification procedure for long-term interventions whose effects are expected to change smoothly over time.

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Hospital corridor

The Effects of Discrete Work Shifts on a Nonterminating Service System

The Effects of Discrete Work Shifts on a Nonterminating Service System

Hospital emergency departments (EDs) provide around‐the‐clock medical care, and as such are generally modeled as nonterminating queues. However, from the care provider's point of view, ED care is not a never‐ending process, but rather occurs in discrete work shifts and may require passing unfinished work to the next care provider at the end of the shift. HIP Investigator, Dr. Brian Patterson et al. used data from a large, academic medical center Emergency Department to show that the patients’ rate of service completion varies over the course of the physician shift. Furthermore, patients that have experienced a physician handoff have a higher rate of service completion than nonhanded off patients.

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