Updates in Pediatric Hospital Medicine: Six Practical Ways to Improve the Care of Hospitalized Children
BACKGROUND: As pediatric hospital medicine continues to grow, it is important to keep abreast of the current literature. This article provides a summary of six of the most impactful articles published in 2018.
METHODS: The authors reviewed articles published between January 2018 and December 2018 for the 2019 Society of Hospital Medicine national conference presentation of Top Articles in Pediatric Hospital Medicine, where the top 10 articles of 2018 were presented. Six of the 10 articles are highlighted in this review based on article quality and their applicability to change practices in the hospital setting or prompt further research.
RESULTS: Key findings from the articles include: multiple interventions aimed at providers can improve compliance with bronchiolitis guidelines; a developed calculator can improve testing for urinary tract infections in children aged 2-24 months; nonmedical costs of hospitalizations are underappreciated and disproportionately affect those with a lower socioeconomic status; a progress note template in an electronic health record can lead to higher quality and shorter notes; for febrile infants aged 60 days and younger, most blood and cerebrospinal fluid culture pathogens can be identified within 24 hours and nearly all by 36 hours; and the development of a high-value care tool can help to bring concepts of high-value care into family-centered rounds.
CONCLUSION: The six selected articles highlight findings pertinent to pediatric hospital medicine.
© 2019 Society of Hospital Medicine
Limitations
This tool was validated at a single pediatric institution, and, thus, the generalizability of the tool has not been established. The authors note that the Delphi panelists used for the construction of the tool were from a medical subspecialty background and not surgical backgrounds, which limits its applicability from a surgical perspective. The tool does not allow for differentiation between lengthy discussions or brief comments presented during rounds.
Important Findings and Implications
The HVC rounding tool is both innovative and timely. Pediatric hospitalists are leaders in family-centered care, and this tool allows assessment of whether important concepts of high-value care are discussed at the bedside. A multisite educational study using this tool would be welcome.
Disclosures
The authors have
