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Faced with the need to improve quality, health care enterprises have used principles from highly reliable industries to make tactical progress. As the health care system faces growing challenges to transform itself, we propose business model innovation as a strategic framework for…
OBJECTIVE: Describe variability in admission, discharge, and occupancy patterns for surgical patients at a large children's hospital and assess the relationship between scheduled admissions and occupancy. BACKGROUND: High hospital occupancy degrades quality of care and access,…
OBJECTIVES: The objective of this study was to test the impact of an education and training intervention about management of common childhood illnesses on caregiver knowledge and health service use by an index child. METHODS: This was a quasi-experimental, preintervention…
OBJECTIVE: To examine whether hospital type (children's hospital or generalist hospital) and surgeon specialty are associated with variations in surgical outcomes for hospitalized adolescents and young adults with inflammatory bowel disease (IBD) requiring surgery. METHODS: The 2007…
Increasing concern about obesity and other nutrition-related health problems spurred governments to develop more robust and targeted approaches to foster healthier diet at a population level (Fulponi, 2009; Kersh & Morone, 2002). Government routinely uses its regulatory power to…
Out-of-hospital cardiac arrest is a major public health problem that affects an estimated 300 000 people in the United States every year. The application of an automated external defibrillator (AED) to patients who have experienced cardiac arrest has saved many lives. AEDs…
OBJECTIVE: Timely, high quality communication with families is essential to family-centered decision-making. Quality communication is represented by widespread documentation of prognostic, goals-of-care conversations (PGOCC) in the pediatric intensive care unit (PICU) and should occur…
In this issue of the journal, Berry et al present a longitudinal study documenting the growth in resource use of freestanding children's hospitals over 5 years. Using a system to classify patients by levels of chronic conditions, the authors report that hospitalizations increased by…
Are children underusing or overusing psychotropic medications in this country? This is the question raised by an article in this month's issue. Contrary to a number of population-based analyses that have described high rates of use, Merikangas et al conclude that many American…
OBJECTIVE: Socioeconomic status (SES) is inversely related to pediatric mortality in the community. However, it is unknown if this association exists for in-hospital pediatric mortality. Our objective was to determine the association of SES with in-hospital pediatric mortality among…