scholarly journals Demographics and utilisation of health services by paediatric refugees from East Africa: implications for service planning and provision

2004 ◽  
Vol 27 (2) ◽  
pp. 40 ◽  
Author(s):  
Regina Cooke ◽  
Sally Murray ◽  
Jonathan Carapetis ◽  
James Rice ◽  
Nigisti Mulholland ◽  
...  
Keyword(s):  
Health Services ◽  
Immigrant Health ◽  
Clinical Epidemiology ◽  
Social Scientist ◽  
Service Planning ◽  
Health Clinic ◽  
Senior Lecturer ◽  
Children's Hospital ◽  
University Of British Columbia ◽  
Children’S Hospital

Regina Cooke is a Clinical Fellow at the Royal Children's Hospital, Melbourne. Sally Murray is an Honorary Fellow of the University of Melbourne and former Program Coordinator of the Victorian Immigrant Health Program, Department of Paediatrics, University of Melbourne. Jonathan Carapetis is an Infectious Diseases Physician, Royal Children's Hospital, Senior Lecturer, Department of Paediatrics,University of Melbourne and Research Fellow, Murdoch Children's Research Institute. James Rice is a Clinical Fellow at University of British Columbia, Canada and formerly of Royal Children's Hospital, Melbourne. Nigisti Mulholland is a Social Scientist, formerly of Royal Children's Hospital, Melbourne.Susan Skull is Deputy Director of the Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, and Senior Lecturer, Department of Paediatrics, University of Melbourne.Little is known of difficulties in accessing health care for recently arrived paediatric refugees in Australia. We reviewedroutinely collected data for all 199 East African children attending a hospital Immigrant Health Clinic for the first time over a 16 month period. Although 63% of parents reported medical consultations since arrival, 77% of this group reported outstanding, unaddressed health problems. Availability of interpreters and information on health services were the main factors hindering access to care. These data have informed future service planning at the Clinic.Ongoing data collection is key to maintaining a responsive, targeted service for a continually changing population.

scholarly journals The Utility of Interaction Design as a Novel Tool to Improve Hand Hygiene Frequency on a Pediatric Hematology-Oncology Ward

2020 ◽  
Vol 41 (S1) ◽  
pp. s411-s411
Author(s):  
Johanna Blaak ◽  
Rachel DiMaio ◽  
Julia Kupis ◽  
Ross Sweetzir ◽  
Conny Betuzzi ◽  
...  
Keyword(s):  
Health Services ◽  
Hand Hygiene ◽  
Interaction Design ◽  
Qualitative Interviews ◽  
Cell Transplant ◽  
Children's Hospital ◽  
University Of Calgary ◽  
Children’S Hospital ◽  
The Mean ◽  
Alberta Health

Johanna Blaak, W21C, University of Calgary; Rachel DiMaio, University of Calgary; Julia Kupis, University of Calgary; Ross Sweetzir, Cisco Systems; Conny Betuzzi, Alberta Children’s Hospital, Alberta Health Services; Corey Dowler, Alberta Children’s Hospital, Alberta Health Services; Krista McIntytre, Alberta Children’s Hospital, Alberta Health Services; Jaime Kaufman, University of Calgary; Greg Hallihan, University of Calgary; John Conly, Foothills Medical Centre; Joseph Vayalumkal, Alberta Childrens HospitalBackground: Interaction design offers a novel interventional strategy to enhance hand-hygiene compliance (HHC) and reduce hospital-acquired infections (HAIs) in the pediatric setting. A quality improvement initiative in collaboration with the University of Calgary and Alberta Health Services led to the implementation of a pilot project with sensor-embedded alcohol -based hand rub (ABHR) dispensers at a hematology-oncology and hematopoietic stem cell transplant unit at Alberta Children’s Hospital (ACH). Methods: Internet of things (IoT) sensors were installed in ABHR dispensers (n = 3) on the unit. Usage data were transmitted to a local server using an MQTT messaging protocol for 16 weeks. Real-time data visualization was presented on a central display next to the nursing station with 11 unique pediatric themes including dinosaurs, transportation, and Canadian animals. Data were collected with and without visualization, and frequency of use (FoU) was determined for both periods. Qualitative interviews with unit stakeholders (n = 13) were held to determine perceptions of the intervention. Results: During the first 8 weeks of the study period, the mean daily use without visualization was 47 times (SD, 14.5) versus 99 times (SD, 23.9) with visualization. When accounting for novelty, by removing the first week of data, the mean daily use was 92 (SD 19.6). The percentage increase from period 1 to period 2 was 96.6%, accounting for novelty. Qualitative interviews with stakeholders (n = 13) on the unit indicated that the intervention increased their personal awareness of hand hygiene (75%) and acted as a constant reminder to perform hand hygiene for everyone on the unit including nonclinical staff, patients, and family members (92%). Conclusions: These limited data suggest that interaction design may improve HH frequency and show promise as a tool for increased HH awareness and education. Interaction design provides a unique, innovative, and acceptable hand hygiene improvement strategy for staff, patients, and families in the pediatric inpatient setting.Funding: NoneDisclosures: None

Training pediatricians for primary medical care

PEDIATRICS ◽  
1974 ◽  
Vol 54 (2) ◽  
pp. 131-133
Author(s):  
Jack G. Shiller
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Medical Care ◽  
Research Training ◽  
Medical Center ◽  
Memorial Lecture ◽  
Recent Issue ◽  
Primary Medical Care ◽  
Children's Hospital ◽  
Children’S Hospital

A recent issue of this Journal carried the Kenneth G. Blackfan Memorial Lecture delivered to the Children's Hospital Alumni Association in Boston on May 30, 1973.1 It was given by Dr. Cicely Williams and entitled "Health Services in the Home." In her message directed at pediatric academia, Dr. Williams essentially said, "Be off with your ultrascience, your superspecialists ... Give thought instead to the thousands who are sick ... Teachers, stop seducing the very best into your snare of enzymes, isotopes and transducers, leaving only a small group to replace our dwindling cohort of primary care deliverers." That very same issue carried a commentary entitled "Primary Medical Care and Medical Research Training" by Dr. David G. Nathan of the Children's Hospital Medical Center.2

scholarly journals Using Administrative Health Data to Define a Cohort of Youth Affected by Chronic Health Conditions: Preparing for Cross-Sectoral Data Linkage

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Kyleigh Schraeder ◽  
Olesya Barrett ◽  
Alberto Nettel-Aguirre ◽  
Gina Dimitropoulos ◽  
Andrew Mackie ◽  
...  
Keyword(s):  
Health Services ◽  
Transition To Adulthood ◽  
Chronic Care ◽  
Data Linkage ◽  
Tertiary Care ◽  
Data Repository ◽  
Area Deprivation ◽  
Care Clinic ◽  
Children's Hospital ◽  
Children’S Hospital

IntroductionIn Alberta, 2,400 youth with chronic needs transition to adulthood every year, and many are not prepared for this change. Transferring youth from pediatric to adult-oriented care is poorly managed. To improve this process, we need to know how youth patients use health services during this period. Objectives and ApproachWe used the Alberta Health Services Corporate Data Repository (CDR-9), which collects records of ambulatory visits, to define a cohort of patients with chronic disease using pediatric tertiary care; data is available from 2008 to 2016. Personal health numbers allowed for deterministic data linkage to CDR-9, registry data (e.g., death dates, moves out of province), and area deprivation indices. Eligible patients were: (a) between ages 12-15 years in 2008 (for ≥2 years observation in adulthood, after age 18), (b) involved with a Chronic Care Clinic (CCC) at Alberta Children’s Hospital, and (c) had repeated CCC visits with ≥3 months between visits. ResultsWe identified 26 Chronic Care Clinics (CCC) at Alberta Children’s Hospital (Calgary, Alberta), with stakeholder input. Using CDR-9, a total of 10,111 patients at the hospital were identified who were 12 to 15 years old at the start of the study window (in 2008), and who visited a CCC before age 18. Less than 1% (n=418) were excluded due to moving out of province or having an invalid personal heath number. Final sample sizes were captured across 3 algorithms (A1, A2, A3), based on frequency of CCC visits within a 2-year period: (i) A1: ≥2 CCC visits (N=4123); (ii) A2: ≥3 CCC visits (N=2242); (iii) A3: ≥4 CCC visits (N=1344). Conclusion/ImplicationsOur identified cohort of youth affected by chronic conditions is the first of its kind in Alberta, and can answer important questions about patterns of service utilization in other sectors of care. Our next step is to link the cohort to population-level datasets (e.g., physician claims, NACRS, CIHI-DAD).

Continuous Improvement Learning for Residents

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_3) ◽  
pp. 768-774
Author(s):  
Linda A. Headrick ◽  
Amy Richardson ◽  
Gregory P. Priebe
Keyword(s):  
Health Care ◽  
Health Services ◽  
Continuous Improvement ◽  
Care Delivery ◽  
Active Role ◽  
Process Of Care ◽  
Children's Hospital ◽  
Services Delivery ◽  
Children’S Hospital ◽  
The Impact

Physicians must be ready to assume an active role in the design, implementation, and improvement of emerging models of health care delivery. Knowledge and skill in continuous improvement prepare them to engage seriously in the processes of change, on the basis of the same scientific principles they always have relied on in the use of evidence to improve outcomes. This includes include the ability to 1) identify the health needs of the individuals and communities for which they provide health services; 2) assess the impact of current practice with appropriate outcome measures; 3) discover what in the process of health care may be contributing to less than desired outcomes; 4) design and test interventions to change the process of care to improve outcomes; 5) act as an effective member of the interdisciplinary team required to complete these tasks; and 6) consider ethical principles and professional values when making decisions about change in health services delivery. Graduate medical education presents special opportunities and challenges for learning about continuous improvement. Early experiences at Rainbow Babies and Children's Hospital in Cleveland and Children's Hospital in Boston suggest how we might prepare pediatricians and other physicians to create positive change and continually improve health care.

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry
Keyword(s):  
Tracheostomy Tube ◽  
Pediatric Population ◽  
Interdisciplinary Approach ◽  
Extended Period ◽  
Speech Development ◽  
Tube Placement ◽  
Background Information ◽  
Speaking Valve ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

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