scholarly journals Analysis of the Design Process of Green Children's Hospitals: Focus on Process Modeling and Lessons Learned

2009 ◽  
Vol 4 (1) ◽  
pp. 121-134 ◽  
Author(s):  
M.M Bilec ◽  
R.J Ries ◽  
K.L Needy ◽  
M Gokhan ◽  
A.F Phelps ◽  
...  
Keyword(s):  
Design Process ◽  
Medical Center ◽  
Children's Hospitals ◽  
Healthcare Facilities ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Complex Design ◽  
Children’S Hospital ◽  
Design Requirements ◽  
The Impact

Healthcare facilities are among the most complicated facilities to plan, design, construct and operate. A new breed of hospitals is considering the impact of the built environment on healthcare worker productivity and patient recovery in their design, construction, and operation. A crucial subset of healthcare facilities are children's hospitals where the consequences of poor building system design and performance have the potential to seriously impact young lives with compromised health. Green facilities are not always pursued: they are perceived as difficult to build and costing more than equivalent conventional hospitals. This study explored the design process of the Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC) and Penn State's Hershey Medical Center Children's Hospital to understand the critical steps and processes for green children's hospital design. Producing a series of process maps that identify the key characteristics in the complex design requirements of a green children's hospital, this paper reveals the importance of design process to design quality. More broadly, this research will help future project teams meet the complex design requirements of green children's hospitals.

scholarly journals To the 90-th Anniversary of Maya K. Bukhrashvili

2021 ◽  
Vol 11 (2) ◽  
pp. 227-231
Author(s):  
Vladimir I. Petlakh
Keyword(s):  
Children's Hospitals ◽  
Professional Activities ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Chief Physician ◽  
Children’S Hospital

Description of the professional activities and merits of the chief physician of one of the oldest children's hospitals in Moscow - .K.A. Timiryazev Children's Hospital №20 - Maya K. Bukhrashvili, celebrating her anniversary.

scholarly journals MENISCUS REPAIR VERSUS DEBRIDEMENT FOR MENISCAL TEARS IN PEDIATRIC PATIENTS – PREDICTORS FOR TREATMENT BASED ON DEMOGRAPHICS

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0016
Author(s):  
Lauren Agatstein ◽  
Alton W. Skaggs ◽  
Matthew J. Brown ◽  
Nicole Friel ◽  
Brian Haus
Keyword(s):  
Pediatric Patients ◽  
Private Insurance ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Meniscus Tear ◽  
Children's Hospitals ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Meniscus Tears ◽  
Children’S Hospital

BACKGROUND: Pediatric and adolescent patients with meniscus tears have a relatively high rate of healing after meniscus repair – up to greater than 80% in the literature. Despite this fact, many patients undergo meniscus debridement for treatment of their meniscus tears. In this study, we investigated the demographic factors predictive of whether a pediatric patient would receive a meniscal repair or a meniscal debridement for their meniscal tear. METHODS: The California statewide ambulatory surgery database (OSHPD) was queried for all patients under 18 years old who underwent meniscus debridement or meniscus repair from 2008-2016. The effect of age, hospital setting (adult versus pediatric hospital), injury chronicity, gender, insurance type, race, and year of service was assessed using logistic regression. RESULTS: A total of 13,906 pediatric patients had meniscal surgery during the timeframe. 83% (11,561/13,906) underwent meniscal debridement and 17% (2,345/13,906) underwent meniscal repair. Age, hospital type, nature of injury, gender, private insurance, being Hispanic, and year of service were statistically significant in predicting the odds of having meniscus repair versus meniscus debridement. Surgery at a children’s hospital increases the odds of having meniscus repair (p < 0.001). Of the 82.6% of pediatric patients (11,491/13,906) treated at non-children’s hospitals, 16% (1839) had repair and 84% underwent debridement (9,652). Of the 17.4% (2,415) treated at children’s hospitals, 21% (506) had repair and 79% (1,909) underwent debridement. As patients age, the odds of receiving a meniscus repair decrease (p < 0.001). Acute meniscus injury (p < 0.001) or private insurance (p < 0.05) increase the odds of having meniscus repair. However, females (p < 0.05) and Hispanics (p < 0.01) had decreased odds of having meniscus repair. As time between injury and surgery progressed, the odds of having meniscus repair versus meniscus debridement increased (p < 0.001). CONCLUSIONS: There is increasing evidence that pediatric patients have successful outcomes after meniscal repair surgery. The results of this study demonstrate that the majority of pediatric patients with meniscus tears undergo a meniscal debridement rather than a repair. Treatment at a children’s hospital, private insurance, and a short time frame between injury and surgery were positive predictors of meniscus repair over debridement. The results of the study may help inform patients, families, and referring physicians about what type of treatment a patient may receive for a meniscus tear, based on their demographic profile.

scholarly journals Impact of the meaningful use incentive program on electronic health record adoption by US children's hospitals

2015 ◽  
Vol 22 (2) ◽  
pp. 390-398 ◽  
Author(s):  
Mari M. Nakamura ◽  
Marvin B. Harper ◽  
Allan V. Castro ◽  
Feliciano B. Yu ◽  
Ashish K. Jha
Keyword(s):  
Electronic Health Record ◽  
Meaningful Use ◽  
Pediatric Care ◽  
Health Record ◽  
Children's Hospitals ◽  
Children's Hospital ◽  
Incentive Program ◽  
Children’S Hospitals ◽  
Children’S Hospital ◽  
Electronic Health

Abstract Objective We determined adoption rates of pediatric-oriented electronic health record (EHR) features by US children's hospitals and assessed perceptions regarding the suitability of commercial EHRs for pediatric care and the influence of the meaningful use incentive program on implementation of pediatric-oriented features. Materials and Methods We surveyed members of the Children's Hospital Association. We measured adoption of 19 pediatric-oriented features and asked whether commercial EHRs include key pediatric-focused capabilities. We inquired about the meaningful use program's relevance to pediatrics and its influence on EHR implementation priorities. Results Of 164 general acute care children's hospitals, 100 (61%) responded to the survey. Rates of comprehensive (across all pediatric units) adoption ranged from 37% (age-, gender-, and weight-adjusted blood pressure percentiles and immunization contraindication warnings) to 87% (age in appropriate units). Implementation rates for several features varied significantly by children's hospital type. Nearly 60% of hospitals reported having EHRs that do not contain all features essential for high-quality care. A majority of hospitals indicated that the meaningful use program has had no effect on their adoption of pediatric features, while 26% said they have delayed or forgone incorporation of such features because of the program. Conclusions Children's hospitals are implementing pediatric-focused features, but a sizable proportion still finds their systems suboptimal for pediatric care. The meaningful use incentive program is failing to promote and in some cases delaying uptake of pediatric-oriented features.

Let's stop looking over our shoulders

PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 345-347
Author(s):  
Abraham B. Bergman
Keyword(s):  
Community Hospital ◽  
Governing Board ◽  
Teaching Program ◽  
Children's Hospitals ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Children’S Hospital ◽  
The Right

Of course, I am biased, but I think the place I work is one of the best children's hospitals in the country. We are both a community hospital, where physicians admit their own private patients, and a university-affiliated hospital with a substantial teaching program, a sometimes tense, but generally beneficial combination. We also have an all-women governing board, which is a blessing for a children's hospital. Their ultimate yardstick on tough decisions is to do what's best for the kids. I'm not smug. My colleagues will testify that I perpetually carry a yard-long laundry list of suggested improvements. Overall, though, I'm proud of our hospital and think we're on the right track.

Impact of Immigration and Migration on Thalassemia Surveillance in California, 2004-2008

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4855-4855
Author(s):  
Susan Paulukonis ◽  
Robert Currier ◽  
Thomas D. Coates ◽  
Elliott Vichinsky ◽  
Lisa Feuchtbaum
Keyword(s):  
Medical Center ◽  
Case Reports ◽  
Thalassemia Major ◽  
Treatment Center ◽  
Beta Thalassemia ◽  
Children's Hospital ◽  
Cooperative Agreement ◽  
Alpha Thalassemia ◽  
Children’S Hospital ◽  
The Impact

Abstract On-going public health surveillance efforts are critical for understanding of the impact and outcomes of thalassemias. California implemented newborn screening (NBS) for beta thalassemia in 1990 and for alpha thalassemia and hemoglobin H (HbH) in 1999; over 99% of all live births are screened. This program has identified hundreds of newborns with these life-threatening disorders, and has led to improved care and outcomes. However the impact of immigration and state-to-state migration of high-risk populations is unknown, and this limits understanding of the prevalence of thalassemia in California. The National Heart, Lung and Blood Institute (NHLBI)-funded and Centers for Disease Control and Prevention (CDC)-directed Registry and Surveillance System for Hemoglobinopathies (RuSH) cooperative agreement collected and linked population-based surveillance data in seven states from a variety of data sources for years 2004-2008. In California, these data included case reports of patients from large specialty treatment centers – Children’s Hospital Los Angeles and UCSF Benioff Children’s Hospital Oakland. In a subsequent CDC cooperative agreement, Public Health Research, Epidemiology and Surveillance in Hemoglobinopathies (PHRESH), California collected additional case reports from four treatment centers: University of California (UC) Davis Medical Center, UC Irvine Medical Center, UC San Francisco Medical Center and UC San Diego Rady Children’s Hospital. We linked reported cases born 1990-2008 to NBS hemoglobinopathy registry thalassemia cases using date of birth, sex, diagnosis and name. There were 273 treatment center reported cases born during the NBS time frame (i.e., 1990-2008 for beta thalassemia, 1999-2008 for alpha thalassemia), including 113 HbH, 46 beta thalassemia major, 20 HbH/Constant Spring, 17 beta thalassemia intermedia, 26 other beta thalassemia, 3 alpha thalassemia major and 48 cases with unknown or unreported genotype. Of the 225 with known genotype, 62% were definite links to the NBS registry, an additional 16% were likely matches (same date of birth, sex and genotype with no other match for that registry case, but different surname) and 21% had no match in the registry. Treatment center reported cases with known genotype not in the NBS registry were more likely to be older (45% unlinked in the oldest age group vs. 12% unlinked in the youngest group) and for 4% (n = 8) of linked cases the treatment center diagnosis differed significantly from the NBS diagnosis. Among the 48 reported cases with unknown genotype, only nine linked to registry cases. Without confirmatory testing, it is unknown whether these cases have thalassemia trait or benign forms of hemoglobin disorders (e.g., Hemoglobin EE) or any form of blood disorder, so interpretation of the lack of linkage among these cases is difficult. Table 1 shows proportions of cases linked (definite and likely matches) and unlinked with the registry by genotype and year. Linked cases from these six treatment centers represented 23% of all NBS registry thalassemia cases for the relevant time period. While California’s strong NBS program is effectively capturing incidence of thalassemias at birth, these data show a high number of cases born out of state or otherwise undiagnosed that may represent migration to the state of high risk populations. These data also do not capture the number of NBS-identified infants who moved out of state during this time period. On-going population-based surveillance for thalassemia is important to monitor changes in prevalence and outcomes among those affected, and informs development of standards of care, policy and advocacy efforts. This work was supported by the CDC and the NHLBI, cooperative agreement numbers U50DD000568 and U50DD001008. Abstract 4855. Table 1: Proportion of Eligible Thalassemia Cases Reported by Treatment Centers Linked to NBS Registry Cases – California, 1990-2009 Unlinked Cases Treatment Center Reported Genotype/Diagnosis Years Screening Begun Total Eligible Treatment Center Cases Linked to NBS Registry 1990-1994 1995-1999 2000-2004 2005-2008 Hemoglobin H 1999 113 105 -- 3 4 1 Hemoglobin H/Constant Spr. 1999 20 16 -- 1 1 2 α thalassemia major 1999 3 3 -- 0 0 0 β thalassemia major 1990 46 27 7 9 2 1 β thalassemia intermedia 1990 17 7 2 4 2 2 β thalassemia other 1990 26 19 1 2 1 3 Total Known Genotype 225 177 10 19 10 9 Genotype unreported -- 48 9 4 10 17 8 Total Reported Cases 273 186 14 29 27 17 Disclosures No relevant conflicts of interest to declare.

PRESIDENT'S MESSAGE

PEDIATRICS ◽  
1961 ◽  
Vol 28 (2) ◽  
pp. 328-330
Author(s):  
George M. Wheatley
Keyword(s):  
Children's Hospitals ◽  
Recent Letter ◽  
Children's Hospital ◽  
Medical Centers ◽  
Children’S Hospitals ◽  
Children’S Hospital ◽  
Pediatric Service ◽  
The University ◽  
Special Hospitals ◽  
Made In

SEVERAL months ago I had the privilege of visiting Winnipeg, in Saskatchewan, Canada, at the invitation of the Academy Chapter there, to address the 52d annual meeting of the Children's Hospital. My talk at the meeting was an effort to answer the question: "What lies ahead for children's hospitals?" I know that many pediatricians and others, much more experienced in this complex subject than I, are seeking the answer. Perhaps exposing you to some excerpts from my Winnipeg talk will stimulate discussion of the future of this important factor in child health. The progress made in the care of children in general hospitals and the strengthening of pediatric service in university medical centers raises the question: "Do we need special hospitals for children?" Dr. J. W. Gerrard, Professor of Paediatrics at the University of Saskatchewan, in a recent letter to me sums up the case for children's hospitals very well. He says: 1. Children's hospitals set the standards of treatment, care and investigations for routine pediatric problems. There is no doubt, for example, that acute infantile gastroenteritis is handled very much more efficiently in a children's hospital by pediatricians than in a general hospital where children are cared for, possibly by pediatricians, but more probably by general practitioners. Not only will the treatment be better in the children's hospital, but the children's hospital will be to an advantage because its services, and in this particular, its biochemical services, will be tailored to meet the needs of children; analyses will be carried out on small amounts of blood, not on the large quantities required by laboratories dealing mainly with adults. 2. A children's hospital is advantageous because not only do perplexing problems, but skilled pediatricians as well, tend to gravitate towards it, and there is always the opportunity, should the need arise, to call in colleagues in consultation. 3. In a children's hospital, common problems tend to be grouped together, e.g., children with leukemia, heart disease, nephrosis and so on, providing the opportunity for pediatricians to specialize in a particular field; they then gain experience which helps to raise the standards of treatment and research in these fields. 4. A children's hospital provides students and interns with a chance to review all or most pediatric problems within a relatively short span of time, so that when they go out into practice they will be able to recognize the rare and the strange, for they will be seeing diseases which they have already had a chance to study and treat. 5. Children's hospitals provide excellent centers for the dissemination of new knowledge to those in practice, particularly at so-called "refresher courses," and in this way keep those in practice up to date.

Improving Stethoscope Disinfection at a Children's Hospital

2013 ◽  
Vol 34 (11) ◽  
pp. 1189-1193 ◽  
Author(s):  
Justin Zaghi ◽  
Jing Zhou ◽  
Dionne A. Graham ◽  
Gail Potter-Bynoe ◽  
Thomas J. Sandora
Keyword(s):  
Pathogenic Bacteria ◽  
Healthcare Providers ◽  
Future Research ◽  
Healthcare Facilities ◽  
Logistic Regression Models ◽  
Children's Hospital ◽  
Contact Precautions ◽  
Before And After ◽  
Children’S Hospital ◽  
The Impact

Objective.Stethoscopes are contaminated with pathogenic bacteria and pose a risk for transmission of infections, but few clinicians disinfect their stethoscope after every use. We sought to improve stethoscope disinfection rates among pediatric healthcare providers by providing access to disinfection materials and visual reminders to disinfect stethoscopes.Design.Prospective intervention study.Setting. Inpatient units and emergency department of a major pediatric hospital.Participants.Physicians and nurses with high anticipated stethoscope use.Methods.Baskets filled with alcohol prep pads and a sticker reminding providers to regularly disinfect stethoscopes were installed outside of patient rooms. Healthcare providers' stethoscope disinfection behaviors were directly observed before and after the intervention. Multivariable logistic regression models were created to identify independent predictors of stethoscope disinfection.Results.Two hundred twenty-six observations were made in the preintervention period and 261 in the postintervention period (83% were of physicians). Stethoscope disinfection compliance increased significantly from a baseline of 34% to 59% postintervention (P < .001). In adjusted analyses, the postintervention period was associated with improved disinfection among both physicians (odds ratio [OR], 2.3 [95% confidence interval (CI), 1.4-3.5]) and nurses (OR, 14.3 [95% CI, 4.6-44.6]). Additional factors independently associated with disinfection included subspecialty unit (vs general pediatrics; OR, 0.5 [95% CI, 0.3-0.8]) and contact precautions (OR, 2.3 [95% CI, 1.2-4.1]).Conclusions.Providing stethoscope disinfection supplies and visible reminders outside of patient rooms significantly increased stethoscope disinfection rates among physicians and nurses at a children's hospital. This simple intervention could be replicated at other healthcare facilities. Future research should assess the impact on patient infections.

scholarly journals SLAP TEARS IN THE PEDIATRIC PATIENT: WHO IS TREATING THEM AND WHERE?

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0005
Author(s):  
Lauren Agatstein ◽  
Matthew J. Brown ◽  
Nicole Friel ◽  
Brian Haus
Keyword(s):  
Sports Medicine ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Children's Hospitals ◽  
Children's Hospital ◽  
Pediatric Hospitals ◽  
Insurance Type ◽  
Slap Repair ◽  
Children’S Hospitals ◽  
Children’S Hospital

BACKGROUND: Although rare in comparison to adult cohorts, superior labral anterior to posterior (SLAP) tears do occur in children and adolescents. Previous publications have focused on the varied surgical treatments of SLAP tears in pediatric hospitals but have not stratified treatments by surgeon training or hospital setting. The objective of this study is to evaluate the demographics of patients under the age of 18 undergoing SLAP surgery as well as to evaluate the influence of hospital setting (hospital self-designation as pediatric vs. non-pediatric) and the trends of treatment choice (debridement versus repair) over a period of time. METHODS: The California statewide outpatient database (OSHPD) was queried for all patients under 18 years old who underwent a SLAP debridement or repair in the state of California between 2008 and 2016. The effect of age, hospital setting (pediatric versus adult hospital), gender, insurance type, race, and year of service were assessed using logistic regression. RESULTS: A total of 1,349 patients under age 18 years underwent surgery for a SLAP tear between 2008 and 2016. SLAP repair was performed in 83.8% of patients while SLAP debridement was performed in 16.2% of patients. 80.9% of patients were treated at non-children’s hospitals and 19.1% were treated at children’s hospitals. At non-children’s hospitals, 161 (14.7%) had SLAP debridement and 931 (85.3%) had SLAP repair. At children’s hospitals, 57 patients (22.2%) had SLAP debridement and 200 (77.8%) had SLAP repair. The odds of having a SLAP repair over SLAP debridement decreases by a factor of .58 (p < 0.01) when patients have surgery at a children’s hospital versus at a non-children’s hospital. Age, gender, race, and insurance type were not statistically significant in predicting whether patients underwent SLAP repair versus debridement. Analysis of each individual year of service over the study period from 2008 to 2016 revealed the odds of having a SLAP repair over debridement increased each year by a factor of 1.1 (p < 0.001). CONCLUSIONS: The majority of surgeries treating SLAP tears in patients under the age of 18 are performed in non-pediatric hospitals. However, previous literature reporting on outcomes of SLAP surgery on patients under 18 is based in tertiary care pediatric centers,, which is likely not representative of this patient population. We hypothesize that this discrepancy may be due to shoulder surgeries more often being performed by sports medicine trained orthopedic surgeons who are not tied to operating in pediatric hospitals. Further, the yearly increased rate of SLAP repair over debridement is likely due to the prevailing knowledge in the orthopedic sports literature that repair is preferable to debridement in younger patients.

At the origins of Saint-Petersburg state pediatric medical university: the contribution by an outstanding pediatrician K. A. Rauchfuss

2014 ◽  
Vol 5 (2) ◽  
pp. 3-13
Author(s):  
Vladimir Viktorovich Levanovich ◽  
Galina Lvovna Mikirtichan ◽  
Irina Aleksandrovna Savina
Keyword(s):  
Children's Hospitals ◽  
Saint Petersburg ◽  
Children's Hospital ◽  
Age Related ◽  
Children’S Hospitals ◽  
Children’S Hospital ◽  
Medical University

Based on archival and published materials, the article describes the activity of an outstanding pediatrician and one of the founders of pediatrics in Russia K. A. Rauchfuss (1835-1915). His contribution to clinical pediatrics, training of pediatricians and the development of new children’s hospitals with regard to the age-related pathology, as well as the style of his management and principles of building relationship with colleagues, patients and their relatives is consi-dered. The role of K. A. Rauchfuss in the organization of the Children’s Hospital in Memory of Sacred Coronation of their Imperial Majesties (Saint-Petersburg, 1905) and his idea to open the Institute for the Protection of Motherhood and Infancy are highlighted. At present, the Saint-Petersburg State Pediatric Medical University is taking steps to commemorate the name of K. A. Rauchfuss, particularly to restore the memorial plaque that was put on the wall of one of the pavilions in 1909.

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