Safety Officer: Hospitalist Support of Safety Practices on a Pediatric Surgical Unit.

Introduction: A quality improvement initiative targeting emergency transfer (ET) rate reduction resulted in the development and implementation of the safety officer (SO) intervention. SO leveraged on-site pediatric hospitalists to promote institutional safety practices around care escalation for all patients admitted to the target unit, including those admitted to surgical subspecialty services.

Methods: An interdisciplinary team developed the SO intervention, which included ad hoc support of communication algorithms and attendance at all Rapid Response Team (RRT) activations on the target unit.

Telepsychiatry Expansion of Inpatient Psychiatry Services During the COVID-19 Pandemic.

During the early COVID-19 pandemic, most psychiatric facilities did not admit SARS-CoV-2-positive youth, resulting in prolonged emergency department (ED) boarding and delayed psychiatric care. In response, our hospital enacted a small, single-site, innovative pilot enabling psychiatric admission of SARS-CoV-2-positive patients with lower behavioral acuity to an inpatient medical unit for comprehensive telepsychiatry programming. Patients transferred to the Telepsychiatry Model from our EDs or hospital medicine service after medical clearance.

Delays to Antibiotics in the Emergency Department and Risk of Mortality in Children With Sepsis.

Importance: Pediatric consensus guidelines recommend antibiotic administration within 1 hour for septic shock and within 3 hours for sepsis without shock. Limited studies exist identifying a specific time past which delays in antibiotic administration are associated with worse outcomes.

Objective: To determine a time point for antibiotic administration that is associated with increased risk of mortality among pediatric patients with sepsis.

IVIG Compared With IVIG Plus Infliximab in Multisystem Inflammatory Syndrome in Children.

Objectives: To compare initial treatment with intravenous immunoglobulin (IVIG) versus IVIG plus infliximab in multisystem inflammatory syndrome in children (MIS-C).

Methods: Single-center retrospective cohort study of patients with MIS-C who met Centers for Disease Control and Prevention criteria and received treatment from April 2020 to February 2021. Patients were included and compared on the basis of initial therapy of either IVIG alone or IVIG plus infliximab.

Confidence-weighted Testing as an Impactful Education Intervention within a Pediatric Sepsis Quality Improvement Initiative.

Introduction: Confidence-weighted testing assesses learners' beliefs about their knowledge and skills. As part of a hospital-wide quality improvement initiative to enhance care for pediatric patients with suspected sepsis, we developed a novel intervention using confidence-weighted testing to identify institutional areas of misinformation and knowledge gaps while also providing real-time feedback to individual learners.

Methods: We developed pediatric sepsis eLearning modules incorporating confidence-weighted testing.

An Acute Care Sepsis Response System Targeting Improved Antibiotic Administration.

Background And Objectives: Pediatric sepsis quality improvement in emergency departments has been well described and associated with improved survival. Acute care (non-ICU inpatient) units differ in important ways, and optimal approaches to improving sepsis processes and outcomes in this setting are not yet known. Our objective was to increase the proportion of acute care sepsis cases in our health system with initial antibiotic order-to-administration time ≤60 minutes by 20% from a baseline of 43% to 52% by December 2020.

Characteristics of Pediatric Rapid Response Systems: Results From a Survey of PRIS Hospitals.

Background: Many hospitals use rapid response systems (RRSs) to identify and intervene on hospitalized children at risk for deterioration.

Objectives: To describe RRS characteristics across hospitals in the Pediatric Research in Inpatient Settings (PRIS) network.

Methods: We developed the survey through a series of prospective respondent, expert, and cognitive interviews.

AutoPEWS: Automating Pediatric Early Warning Score Calculation Improves Accuracy Without Sacrificing Predictive Ability.

Introduction: Pediatric early warning scores (PEWS) identify hospitalized children at risk for deterioration. Manual calculation is prone to human error. Electronic health records (EHRs) enable automated calculation, removing human error.