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Clinical question: What is the rate of symptomatic upper-extremity DVT (UEDVT), and what are the predictors of UEDVT development in a cohort of hospitalized patients with peripherally inserted central catheters (PICCs)?

Background: PICCs are used in hospitalized patients and increase VTE risk. Investigators in this study sought to determine the incidence of VTE associated with PICCs in a cohort of hospitalized patients.

Study design: Retrospective chart review.

Setting: University-affiliated community hospital in Memphis, Tenn.

Synopsis: Over a three-month period, 954 PICCs were placed in 777 patients. Ninety percent of the patients were placed due to poor venous access. Thirty-eight (4.89%) developed at least one VTE, giving a rate of 5.10 VTEs per 1,000 PICC-days; 27 (3.47%) developed UEDVT, giving a rate of 3.65 UEDVTs per 1,000 PICC-days; eight (1.03%) had PE. Patients with VTE had a significantly longer LOS (26 days vs. 15.8 days), and average PICC-days were significantly longer in patients with VTE (13 days vs. 9 days).

In multivariate analysis, the strongest predictors of PICC-associated VTE were previous history of VTE (OR 10.83, 95% CI, 4.89-23.95), PICC tip in noncentral location (OR 2.61, 95% CI, 1.28-5.35), and duration of stay in 10-day increments (OR 1.21, 95% CI, 1.07-1.37).

This study likely underestimates the rate of VTE because symptomatic VTE specifically was assessed. This study and other studies indicate that VTE occurrence in patients with PICC lines is significant; more judicious use of PICC lines is needed and minimizing the length of time PICC lines are in place is important.

Bottom line: In hospitalized patients with PICC lines, previous history of VTE, noncentral location of the PICC tip, and duration of placement are significant predictors of VTE.

 

Citation: Lobo BL, Vaidean G, Broyles J, Reaves AB, Shorr RI. Risk of venous thromboembolism in hospitalized patients with peripherally inserted central catheters. J Hosp Med. 2009;4(7):417-422.

Reviewed for TH eWire by Sameer Badlani, MD, Stacy S. Banerjee, MD, Alan J. Jung, MD, Elizabeth Marlow, MD, MPP, Valerie G. Press, MD, MPH, Milda R. Saunders, MD, MPH, Nilam J. Soni, MD, Srilaxmi Tumuluri, MD, Section of Hospital Medicine, University of Chicago

For more reviews of HM-related literature, visit our Web site.

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Clinical question: What is the rate of symptomatic upper-extremity DVT (UEDVT), and what are the predictors of UEDVT development in a cohort of hospitalized patients with peripherally inserted central catheters (PICCs)?

Background: PICCs are used in hospitalized patients and increase VTE risk. Investigators in this study sought to determine the incidence of VTE associated with PICCs in a cohort of hospitalized patients.

Study design: Retrospective chart review.

Setting: University-affiliated community hospital in Memphis, Tenn.

Synopsis: Over a three-month period, 954 PICCs were placed in 777 patients. Ninety percent of the patients were placed due to poor venous access. Thirty-eight (4.89%) developed at least one VTE, giving a rate of 5.10 VTEs per 1,000 PICC-days; 27 (3.47%) developed UEDVT, giving a rate of 3.65 UEDVTs per 1,000 PICC-days; eight (1.03%) had PE. Patients with VTE had a significantly longer LOS (26 days vs. 15.8 days), and average PICC-days were significantly longer in patients with VTE (13 days vs. 9 days).

In multivariate analysis, the strongest predictors of PICC-associated VTE were previous history of VTE (OR 10.83, 95% CI, 4.89-23.95), PICC tip in noncentral location (OR 2.61, 95% CI, 1.28-5.35), and duration of stay in 10-day increments (OR 1.21, 95% CI, 1.07-1.37).

This study likely underestimates the rate of VTE because symptomatic VTE specifically was assessed. This study and other studies indicate that VTE occurrence in patients with PICC lines is significant; more judicious use of PICC lines is needed and minimizing the length of time PICC lines are in place is important.

Bottom line: In hospitalized patients with PICC lines, previous history of VTE, noncentral location of the PICC tip, and duration of placement are significant predictors of VTE.

 

Citation: Lobo BL, Vaidean G, Broyles J, Reaves AB, Shorr RI. Risk of venous thromboembolism in hospitalized patients with peripherally inserted central catheters. J Hosp Med. 2009;4(7):417-422.

Reviewed for TH eWire by Sameer Badlani, MD, Stacy S. Banerjee, MD, Alan J. Jung, MD, Elizabeth Marlow, MD, MPP, Valerie G. Press, MD, MPH, Milda R. Saunders, MD, MPH, Nilam J. Soni, MD, Srilaxmi Tumuluri, MD, Section of Hospital Medicine, University of Chicago

For more reviews of HM-related literature, visit our Web site.

Clinical question: What is the rate of symptomatic upper-extremity DVT (UEDVT), and what are the predictors of UEDVT development in a cohort of hospitalized patients with peripherally inserted central catheters (PICCs)?

Background: PICCs are used in hospitalized patients and increase VTE risk. Investigators in this study sought to determine the incidence of VTE associated with PICCs in a cohort of hospitalized patients.

Study design: Retrospective chart review.

Setting: University-affiliated community hospital in Memphis, Tenn.

Synopsis: Over a three-month period, 954 PICCs were placed in 777 patients. Ninety percent of the patients were placed due to poor venous access. Thirty-eight (4.89%) developed at least one VTE, giving a rate of 5.10 VTEs per 1,000 PICC-days; 27 (3.47%) developed UEDVT, giving a rate of 3.65 UEDVTs per 1,000 PICC-days; eight (1.03%) had PE. Patients with VTE had a significantly longer LOS (26 days vs. 15.8 days), and average PICC-days were significantly longer in patients with VTE (13 days vs. 9 days).

In multivariate analysis, the strongest predictors of PICC-associated VTE were previous history of VTE (OR 10.83, 95% CI, 4.89-23.95), PICC tip in noncentral location (OR 2.61, 95% CI, 1.28-5.35), and duration of stay in 10-day increments (OR 1.21, 95% CI, 1.07-1.37).

This study likely underestimates the rate of VTE because symptomatic VTE specifically was assessed. This study and other studies indicate that VTE occurrence in patients with PICC lines is significant; more judicious use of PICC lines is needed and minimizing the length of time PICC lines are in place is important.

Bottom line: In hospitalized patients with PICC lines, previous history of VTE, noncentral location of the PICC tip, and duration of placement are significant predictors of VTE.

 

Citation: Lobo BL, Vaidean G, Broyles J, Reaves AB, Shorr RI. Risk of venous thromboembolism in hospitalized patients with peripherally inserted central catheters. J Hosp Med. 2009;4(7):417-422.

Reviewed for TH eWire by Sameer Badlani, MD, Stacy S. Banerjee, MD, Alan J. Jung, MD, Elizabeth Marlow, MD, MPP, Valerie G. Press, MD, MPH, Milda R. Saunders, MD, MPH, Nilam J. Soni, MD, Srilaxmi Tumuluri, MD, Section of Hospital Medicine, University of Chicago

For more reviews of HM-related literature, visit our Web site.

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SHM President: 'Take Charge of QI'

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NATIONAL HARBOR, Md. — The HM movement over the past two decades has matured into a defined specialty, but must now take charge of quality improvement (QI) in hospital settings if it hopes to “go to that next level,” the new SHM president declared at the annual meeting this morning.

“We’re at a stage as an organization that we need to continue to do the quality education efforts, but we need to start rising to that next level, which is the quality execution and solutions,” said President Jeffrey Wiese, MD, FACP, SFHM, associate professor of medicine at Tulane University Health Sciences Center in New Orleans.

Dr. Wiese said that within five years he expects SHM to have crafted an interactive database listing all HM-led QI projects. He envisions the information as a resource for hospitalists looking to lead projects, as well as a “grand menu of potential practice improvement modules” to satisfy the new Focused Practice in Hospital Medicine Maintenance of Certification through the American Board of Internal Medicine (ABIM).

“We have great heterogeneity in the society,” Dr. Wiese said after his address. “Some people are quality experts because they received great training from SHM, Intermountain Health, IHI, but then there are many members that are interested and really want to be that quality expert, but are to the left on the continuum, still learning how to do it."

The new president capped a morning of speechifying from outgoing President Scott Flanders, MD, SFHM, director of the hospitalist division, University of Michigan Health System, Ann Arbor, and SHM CEO Larry Wellikson, MD, SFHM. Both reveled in HM’s growth, but agreed that to sustain that momentum more of the estimated 30,000 hospitalists in the U.S. need to get more involved in promoting and pushing the practice.

“We really need to engage everybody," Dr. Flanders said. "We need all 60,000 hands on deck.”

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NATIONAL HARBOR, Md. — The HM movement over the past two decades has matured into a defined specialty, but must now take charge of quality improvement (QI) in hospital settings if it hopes to “go to that next level,” the new SHM president declared at the annual meeting this morning.

“We’re at a stage as an organization that we need to continue to do the quality education efforts, but we need to start rising to that next level, which is the quality execution and solutions,” said President Jeffrey Wiese, MD, FACP, SFHM, associate professor of medicine at Tulane University Health Sciences Center in New Orleans.

Dr. Wiese said that within five years he expects SHM to have crafted an interactive database listing all HM-led QI projects. He envisions the information as a resource for hospitalists looking to lead projects, as well as a “grand menu of potential practice improvement modules” to satisfy the new Focused Practice in Hospital Medicine Maintenance of Certification through the American Board of Internal Medicine (ABIM).

“We have great heterogeneity in the society,” Dr. Wiese said after his address. “Some people are quality experts because they received great training from SHM, Intermountain Health, IHI, but then there are many members that are interested and really want to be that quality expert, but are to the left on the continuum, still learning how to do it."

The new president capped a morning of speechifying from outgoing President Scott Flanders, MD, SFHM, director of the hospitalist division, University of Michigan Health System, Ann Arbor, and SHM CEO Larry Wellikson, MD, SFHM. Both reveled in HM’s growth, but agreed that to sustain that momentum more of the estimated 30,000 hospitalists in the U.S. need to get more involved in promoting and pushing the practice.

“We really need to engage everybody," Dr. Flanders said. "We need all 60,000 hands on deck.”

NATIONAL HARBOR, Md. — The HM movement over the past two decades has matured into a defined specialty, but must now take charge of quality improvement (QI) in hospital settings if it hopes to “go to that next level,” the new SHM president declared at the annual meeting this morning.

“We’re at a stage as an organization that we need to continue to do the quality education efforts, but we need to start rising to that next level, which is the quality execution and solutions,” said President Jeffrey Wiese, MD, FACP, SFHM, associate professor of medicine at Tulane University Health Sciences Center in New Orleans.

Dr. Wiese said that within five years he expects SHM to have crafted an interactive database listing all HM-led QI projects. He envisions the information as a resource for hospitalists looking to lead projects, as well as a “grand menu of potential practice improvement modules” to satisfy the new Focused Practice in Hospital Medicine Maintenance of Certification through the American Board of Internal Medicine (ABIM).

“We have great heterogeneity in the society,” Dr. Wiese said after his address. “Some people are quality experts because they received great training from SHM, Intermountain Health, IHI, but then there are many members that are interested and really want to be that quality expert, but are to the left on the continuum, still learning how to do it."

The new president capped a morning of speechifying from outgoing President Scott Flanders, MD, SFHM, director of the hospitalist division, University of Michigan Health System, Ann Arbor, and SHM CEO Larry Wellikson, MD, SFHM. Both reveled in HM’s growth, but agreed that to sustain that momentum more of the estimated 30,000 hospitalists in the U.S. need to get more involved in promoting and pushing the practice.

“We really need to engage everybody," Dr. Flanders said. "We need all 60,000 hands on deck.”

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Researchers Earn First SHM Junior Faculty Development Awards

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NATIONAL HARBOR, Md. — Kirsten Kangelaris, MD, and Evan Fieldston, MD, MBA, MSHP, were presented $50,000 Junior Faculty Development Awards this morning at HM10. The first-year awards are part of SHM’s commitment to helping the “generation of new knowledge,” said Scott Flanders, SHM’s outgoing president.

Dr. Kangelaris, a fellow in internal medicine at the University of California at San Francisco, focuses her research on continued clinical and biologic genetic risk-prediction algorithms that will improve the triage and early-management strategies for hospitalized patients with inflammatory illness.

Dr. Fieldston, an assistant professor in pediatrics at the University of Pennsylvania School of Medicine and Children’s Hospital of Philadelphia, plans to use his award to examine the association between dynamic aspects of workload, workforce, and quality of care at children’s hospitals.

SHM also handed out its annual Awards of Excellence and announced winners from the Research, Innovation, and Clinical Vignette (PDF) competition. Judges scored more than 400 posters; some of the winning project teams included medical students.

“I am particularly proud to see that we had medical students as award winners,” said Flanders, chief of the hospital medicine division at the University of Michigan Health System in Ann Arbor. “That gives me great hope for the future of HM.”

 

Awards of Excellence

  • Clinical Excellence: Jennifer Myers (pictured), MD, FHM, patient safety officer at the Hospital of the University of Pennsylvania;
  • Excellence in Research: Margaret Fang, MD, MPH, FHM, assistant professor of medicine at the University of California at San Francisco;
  • Outstanding Service in Hospital Medicine: Mitchell Wilson, MD, SFHM, corporate medical director for Eagle Hospital Physicians;
  • Excellence in Teaching: Amir Jaffer, associate professor of medicine, chief of the hospital medicine division in the Department of Medicine at the University of Miami (Fla.); and
  • Excellence in Teamwork in Quality Improvement: Emory Healthcare’s VTE Prevention Team.

Research, Innovation, and Clinical Vignettes winners

  • Research: Will Southern, MD, MS, and Julia Arnsten, MD, MPH, Montefiore Medical Center, Bronx, N.Y.: “Increased Mortality and Readmission Among Patients Discharged against Medical Advice.”
  • Innovation Poster: Aaron Farberg, BS, Andrew Lin, BS, Latoya Kuhn, MPH, Scott Flanders, MD, SFHM, Christopher Kim, MD, MBA, University of Michigan Medical School, “Dear Doctor: A Tool to Facilitate Patient-Centered Care and Enhance Communication.”
  • Adult Vignette: Jennie Wei, MD, and Patrick Kneeland, MD, University of California at San Francisco, “A Case of Skin Ulcers and Neutropenia: Definitely Not a Helminth Problem.”
  • Pediatric Vignette: Harry Hoar, MD, Baystate Children’s Hospitalist, Springfield, Mass., “A Teen with Varices: An Uncommon Presentation of a Familiar Disease.”
  •  

     

 

 

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NATIONAL HARBOR, Md. — Kirsten Kangelaris, MD, and Evan Fieldston, MD, MBA, MSHP, were presented $50,000 Junior Faculty Development Awards this morning at HM10. The first-year awards are part of SHM’s commitment to helping the “generation of new knowledge,” said Scott Flanders, SHM’s outgoing president.

Dr. Kangelaris, a fellow in internal medicine at the University of California at San Francisco, focuses her research on continued clinical and biologic genetic risk-prediction algorithms that will improve the triage and early-management strategies for hospitalized patients with inflammatory illness.

Dr. Fieldston, an assistant professor in pediatrics at the University of Pennsylvania School of Medicine and Children’s Hospital of Philadelphia, plans to use his award to examine the association between dynamic aspects of workload, workforce, and quality of care at children’s hospitals.

SHM also handed out its annual Awards of Excellence and announced winners from the Research, Innovation, and Clinical Vignette (PDF) competition. Judges scored more than 400 posters; some of the winning project teams included medical students.

“I am particularly proud to see that we had medical students as award winners,” said Flanders, chief of the hospital medicine division at the University of Michigan Health System in Ann Arbor. “That gives me great hope for the future of HM.”

 

Awards of Excellence

  • Clinical Excellence: Jennifer Myers (pictured), MD, FHM, patient safety officer at the Hospital of the University of Pennsylvania;
  • Excellence in Research: Margaret Fang, MD, MPH, FHM, assistant professor of medicine at the University of California at San Francisco;
  • Outstanding Service in Hospital Medicine: Mitchell Wilson, MD, SFHM, corporate medical director for Eagle Hospital Physicians;
  • Excellence in Teaching: Amir Jaffer, associate professor of medicine, chief of the hospital medicine division in the Department of Medicine at the University of Miami (Fla.); and
  • Excellence in Teamwork in Quality Improvement: Emory Healthcare’s VTE Prevention Team.

Research, Innovation, and Clinical Vignettes winners

  • Research: Will Southern, MD, MS, and Julia Arnsten, MD, MPH, Montefiore Medical Center, Bronx, N.Y.: “Increased Mortality and Readmission Among Patients Discharged against Medical Advice.”
  • Innovation Poster: Aaron Farberg, BS, Andrew Lin, BS, Latoya Kuhn, MPH, Scott Flanders, MD, SFHM, Christopher Kim, MD, MBA, University of Michigan Medical School, “Dear Doctor: A Tool to Facilitate Patient-Centered Care and Enhance Communication.”
  • Adult Vignette: Jennie Wei, MD, and Patrick Kneeland, MD, University of California at San Francisco, “A Case of Skin Ulcers and Neutropenia: Definitely Not a Helminth Problem.”
  • Pediatric Vignette: Harry Hoar, MD, Baystate Children’s Hospitalist, Springfield, Mass., “A Teen with Varices: An Uncommon Presentation of a Familiar Disease.”
  •  

     

 

 

NATIONAL HARBOR, Md. — Kirsten Kangelaris, MD, and Evan Fieldston, MD, MBA, MSHP, were presented $50,000 Junior Faculty Development Awards this morning at HM10. The first-year awards are part of SHM’s commitment to helping the “generation of new knowledge,” said Scott Flanders, SHM’s outgoing president.

Dr. Kangelaris, a fellow in internal medicine at the University of California at San Francisco, focuses her research on continued clinical and biologic genetic risk-prediction algorithms that will improve the triage and early-management strategies for hospitalized patients with inflammatory illness.

Dr. Fieldston, an assistant professor in pediatrics at the University of Pennsylvania School of Medicine and Children’s Hospital of Philadelphia, plans to use his award to examine the association between dynamic aspects of workload, workforce, and quality of care at children’s hospitals.

SHM also handed out its annual Awards of Excellence and announced winners from the Research, Innovation, and Clinical Vignette (PDF) competition. Judges scored more than 400 posters; some of the winning project teams included medical students.

“I am particularly proud to see that we had medical students as award winners,” said Flanders, chief of the hospital medicine division at the University of Michigan Health System in Ann Arbor. “That gives me great hope for the future of HM.”

 

Awards of Excellence

  • Clinical Excellence: Jennifer Myers (pictured), MD, FHM, patient safety officer at the Hospital of the University of Pennsylvania;
  • Excellence in Research: Margaret Fang, MD, MPH, FHM, assistant professor of medicine at the University of California at San Francisco;
  • Outstanding Service in Hospital Medicine: Mitchell Wilson, MD, SFHM, corporate medical director for Eagle Hospital Physicians;
  • Excellence in Teaching: Amir Jaffer, associate professor of medicine, chief of the hospital medicine division in the Department of Medicine at the University of Miami (Fla.); and
  • Excellence in Teamwork in Quality Improvement: Emory Healthcare’s VTE Prevention Team.

Research, Innovation, and Clinical Vignettes winners

  • Research: Will Southern, MD, MS, and Julia Arnsten, MD, MPH, Montefiore Medical Center, Bronx, N.Y.: “Increased Mortality and Readmission Among Patients Discharged against Medical Advice.”
  • Innovation Poster: Aaron Farberg, BS, Andrew Lin, BS, Latoya Kuhn, MPH, Scott Flanders, MD, SFHM, Christopher Kim, MD, MBA, University of Michigan Medical School, “Dear Doctor: A Tool to Facilitate Patient-Centered Care and Enhance Communication.”
  • Adult Vignette: Jennie Wei, MD, and Patrick Kneeland, MD, University of California at San Francisco, “A Case of Skin Ulcers and Neutropenia: Definitely Not a Helminth Problem.”
  • Pediatric Vignette: Harry Hoar, MD, Baystate Children’s Hospitalist, Springfield, Mass., “A Teen with Varices: An Uncommon Presentation of a Familiar Disease.”
  •  

     

 

 

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Health Reform Heading HM's Way

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NATIONAL HARBOR, Md. – Hospitalists are poised to take the reins of implementing the landmark healthcare reform package signed into law two weeks ago.

“It creates challenges for us; it creates great opportunities for us,” Ron Greeno, MD, FCCP, SFHM, chief medical officer of Brentwood, Tenn.-based Cogent Healthcare, and a member of SHM’s Public Policy Committee, said during a panel discussion this morning at HM10. “Saddle up, because we’re going to be asked to do a lot of things.”

Just what the most meaningful healthcare legislation since Medicare was passed in 1965 will mean for hospitalists is murky. Eric Siegal, MD, SFHM, chair of SHM’s Public Policy Committee, noted that a skeptic can look at bundling payments as a negative influence on HM compensation, while a supporter might argue that a revised revenue methodology could streamline operations, align interests and eventually be a boon to the bottom line.

Either way, outgoing SHM President Scott Flanders, MD, SFHM, director of the hospitalist division at the University of Michigan Health System in Ann Arbor, wants all hospitalists to be prepared for inevitable discussions of how to improve quality of care and reduce costs.

“The timing couldn’t be more fortuitous,” Dr. Flanders said, referring to the fact the annual meeting is being held just miles from the Capitol. “We are about to experience some sea changes in healthcare in the United States.”

Leslie Norwalk, former acting administrator of the Centers for Medicare and Medicaid Services (CMS), noted that much of the reform would hinge on pay incentives and the ability to properly fund programs that encourage new ideas, particularly the proposed Council on Technology and Innovation. Without proper funding, many elements of the health reform legislation could go by the wayside, said Norwalk, now a lawyer in Washington.

“You get what you pay for,” she added. “If you stop paying for readmission—at least avoidable readmission…then I imagine that this trend would change.”

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NATIONAL HARBOR, Md. – Hospitalists are poised to take the reins of implementing the landmark healthcare reform package signed into law two weeks ago.

“It creates challenges for us; it creates great opportunities for us,” Ron Greeno, MD, FCCP, SFHM, chief medical officer of Brentwood, Tenn.-based Cogent Healthcare, and a member of SHM’s Public Policy Committee, said during a panel discussion this morning at HM10. “Saddle up, because we’re going to be asked to do a lot of things.”

Just what the most meaningful healthcare legislation since Medicare was passed in 1965 will mean for hospitalists is murky. Eric Siegal, MD, SFHM, chair of SHM’s Public Policy Committee, noted that a skeptic can look at bundling payments as a negative influence on HM compensation, while a supporter might argue that a revised revenue methodology could streamline operations, align interests and eventually be a boon to the bottom line.

Either way, outgoing SHM President Scott Flanders, MD, SFHM, director of the hospitalist division at the University of Michigan Health System in Ann Arbor, wants all hospitalists to be prepared for inevitable discussions of how to improve quality of care and reduce costs.

“The timing couldn’t be more fortuitous,” Dr. Flanders said, referring to the fact the annual meeting is being held just miles from the Capitol. “We are about to experience some sea changes in healthcare in the United States.”

Leslie Norwalk, former acting administrator of the Centers for Medicare and Medicaid Services (CMS), noted that much of the reform would hinge on pay incentives and the ability to properly fund programs that encourage new ideas, particularly the proposed Council on Technology and Innovation. Without proper funding, many elements of the health reform legislation could go by the wayside, said Norwalk, now a lawyer in Washington.

“You get what you pay for,” she added. “If you stop paying for readmission—at least avoidable readmission…then I imagine that this trend would change.”

NATIONAL HARBOR, Md. – Hospitalists are poised to take the reins of implementing the landmark healthcare reform package signed into law two weeks ago.

“It creates challenges for us; it creates great opportunities for us,” Ron Greeno, MD, FCCP, SFHM, chief medical officer of Brentwood, Tenn.-based Cogent Healthcare, and a member of SHM’s Public Policy Committee, said during a panel discussion this morning at HM10. “Saddle up, because we’re going to be asked to do a lot of things.”

Just what the most meaningful healthcare legislation since Medicare was passed in 1965 will mean for hospitalists is murky. Eric Siegal, MD, SFHM, chair of SHM’s Public Policy Committee, noted that a skeptic can look at bundling payments as a negative influence on HM compensation, while a supporter might argue that a revised revenue methodology could streamline operations, align interests and eventually be a boon to the bottom line.

Either way, outgoing SHM President Scott Flanders, MD, SFHM, director of the hospitalist division at the University of Michigan Health System in Ann Arbor, wants all hospitalists to be prepared for inevitable discussions of how to improve quality of care and reduce costs.

“The timing couldn’t be more fortuitous,” Dr. Flanders said, referring to the fact the annual meeting is being held just miles from the Capitol. “We are about to experience some sea changes in healthcare in the United States.”

Leslie Norwalk, former acting administrator of the Centers for Medicare and Medicaid Services (CMS), noted that much of the reform would hinge on pay incentives and the ability to properly fund programs that encourage new ideas, particularly the proposed Council on Technology and Innovation. Without proper funding, many elements of the health reform legislation could go by the wayside, said Norwalk, now a lawyer in Washington.

“You get what you pay for,” she added. “If you stop paying for readmission—at least avoidable readmission…then I imagine that this trend would change.”

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First, Do No Harm

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NATIONAL HARBOR, Md. — Paul Levy doesn’t take well to the idea that things just happen in a hospital, whether it’s a central-line infection, a patient fall, or an accommodation for excellence.

Levy, president and CEO of Beth Israel Deaconess Medical Center in Boston, insists that improvement be a central tenet of his institution—and the only way to improve things is to monitor them first to establish a baseline.

Many of the roughly 2,500 hospitalists gathered for HM10 here might have expected Levy to talk about the recently passed healthcare reform package. Surprisingly, he instead told them to “ignore the healthcare reform bill" during this morning’s keynote address.

“Ignore all the fuss about it," he said. "Focus instead on the underlying values that you each have individually, and that you have collectively, as to why you became docs in the first place.”

Levy, who is not a physician, has quickly made a name as a leading voice in quality and transparency discussions, particularly via his popular blog. This morning, he told thousands of hospitalists that while change can be difficult, “we are doing too much harm in our hospitals.” He encouraged hospitalists to take charge of quality programs and point out processes and systems that could be improved.

And while he didn’t discount the federal mandate to provide increased access to medical care, he noted that the future delivery of care will improve as a function of thoughtful analysis and dedicated work, not because of new budgeting rules.

“It won’t be because we changed the payment regime,” Levy boasted. “It will be because you did the job.”

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NATIONAL HARBOR, Md. — Paul Levy doesn’t take well to the idea that things just happen in a hospital, whether it’s a central-line infection, a patient fall, or an accommodation for excellence.

Levy, president and CEO of Beth Israel Deaconess Medical Center in Boston, insists that improvement be a central tenet of his institution—and the only way to improve things is to monitor them first to establish a baseline.

Many of the roughly 2,500 hospitalists gathered for HM10 here might have expected Levy to talk about the recently passed healthcare reform package. Surprisingly, he instead told them to “ignore the healthcare reform bill" during this morning’s keynote address.

“Ignore all the fuss about it," he said. "Focus instead on the underlying values that you each have individually, and that you have collectively, as to why you became docs in the first place.”

Levy, who is not a physician, has quickly made a name as a leading voice in quality and transparency discussions, particularly via his popular blog. This morning, he told thousands of hospitalists that while change can be difficult, “we are doing too much harm in our hospitals.” He encouraged hospitalists to take charge of quality programs and point out processes and systems that could be improved.

And while he didn’t discount the federal mandate to provide increased access to medical care, he noted that the future delivery of care will improve as a function of thoughtful analysis and dedicated work, not because of new budgeting rules.

“It won’t be because we changed the payment regime,” Levy boasted. “It will be because you did the job.”

NATIONAL HARBOR, Md. — Paul Levy doesn’t take well to the idea that things just happen in a hospital, whether it’s a central-line infection, a patient fall, or an accommodation for excellence.

Levy, president and CEO of Beth Israel Deaconess Medical Center in Boston, insists that improvement be a central tenet of his institution—and the only way to improve things is to monitor them first to establish a baseline.

Many of the roughly 2,500 hospitalists gathered for HM10 here might have expected Levy to talk about the recently passed healthcare reform package. Surprisingly, he instead told them to “ignore the healthcare reform bill" during this morning’s keynote address.

“Ignore all the fuss about it," he said. "Focus instead on the underlying values that you each have individually, and that you have collectively, as to why you became docs in the first place.”

Levy, who is not a physician, has quickly made a name as a leading voice in quality and transparency discussions, particularly via his popular blog. This morning, he told thousands of hospitalists that while change can be difficult, “we are doing too much harm in our hospitals.” He encouraged hospitalists to take charge of quality programs and point out processes and systems that could be improved.

And while he didn’t discount the federal mandate to provide increased access to medical care, he noted that the future delivery of care will improve as a function of thoughtful analysis and dedicated work, not because of new budgeting rules.

“It won’t be because we changed the payment regime,” Levy boasted. “It will be because you did the job.”

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California HealthCare Foundation Adopts Project BOOST

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NATIONAL HARBOR, Md. – The next cohort of sites for SHM’s transitional-care program will be 20 California hospitals and health centers.

The agreement to expand Project BOOST (Better Outcomes for Older Adults through Safer Transitions) was made public by society cofounder Win Whitcomb, MD, MHM, chief quality officer at Mercy Medical Center in Springfield, Mass., during an academic pre-course session Thursday at HM10 just outside Washington, D.C.

It’s the second major expansion of the program this year. In January, 15 sites in Michigan entered into a collaborative BOOST program to be comanaged by the University of Michigan and Blue Cross Blue Shield of Michigan. Although details are still pending for the California model, it will be a collaboration with the California HealthCare Foundation, an independent nonprofit focused on improving healthcare and reducing costs in the Golden State.

BOOST works by pairing mentors with hospitalists at select institutions to improve care via a discharge planning toolkit. BOOST debuted late in 2008 with six pilot sites. After the California additions, the platform will have expanded to 65 sites.

Dr. Whitcomb’s news was just one of the tidbits tossed out during the practice management pre-course, one of eight daylong courses for hospitalists. Two new pre-courses debuted this year: “Early Career Hospitalist: Skills for Success” and “Essential Neurology for the Hospitalist.”

“It’s a very good learning environment where you can sit down and focus,” said Julius Yang, MD, PhD, a hospitalist at Beth Israel Deaconess Medical Center in Boston and the course director for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) learning session. “It allows you to really immerse yourself in the information.”

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NATIONAL HARBOR, Md. – The next cohort of sites for SHM’s transitional-care program will be 20 California hospitals and health centers.

The agreement to expand Project BOOST (Better Outcomes for Older Adults through Safer Transitions) was made public by society cofounder Win Whitcomb, MD, MHM, chief quality officer at Mercy Medical Center in Springfield, Mass., during an academic pre-course session Thursday at HM10 just outside Washington, D.C.

It’s the second major expansion of the program this year. In January, 15 sites in Michigan entered into a collaborative BOOST program to be comanaged by the University of Michigan and Blue Cross Blue Shield of Michigan. Although details are still pending for the California model, it will be a collaboration with the California HealthCare Foundation, an independent nonprofit focused on improving healthcare and reducing costs in the Golden State.

BOOST works by pairing mentors with hospitalists at select institutions to improve care via a discharge planning toolkit. BOOST debuted late in 2008 with six pilot sites. After the California additions, the platform will have expanded to 65 sites.

Dr. Whitcomb’s news was just one of the tidbits tossed out during the practice management pre-course, one of eight daylong courses for hospitalists. Two new pre-courses debuted this year: “Early Career Hospitalist: Skills for Success” and “Essential Neurology for the Hospitalist.”

“It’s a very good learning environment where you can sit down and focus,” said Julius Yang, MD, PhD, a hospitalist at Beth Israel Deaconess Medical Center in Boston and the course director for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) learning session. “It allows you to really immerse yourself in the information.”

NATIONAL HARBOR, Md. – The next cohort of sites for SHM’s transitional-care program will be 20 California hospitals and health centers.

The agreement to expand Project BOOST (Better Outcomes for Older Adults through Safer Transitions) was made public by society cofounder Win Whitcomb, MD, MHM, chief quality officer at Mercy Medical Center in Springfield, Mass., during an academic pre-course session Thursday at HM10 just outside Washington, D.C.

It’s the second major expansion of the program this year. In January, 15 sites in Michigan entered into a collaborative BOOST program to be comanaged by the University of Michigan and Blue Cross Blue Shield of Michigan. Although details are still pending for the California model, it will be a collaboration with the California HealthCare Foundation, an independent nonprofit focused on improving healthcare and reducing costs in the Golden State.

BOOST works by pairing mentors with hospitalists at select institutions to improve care via a discharge planning toolkit. BOOST debuted late in 2008 with six pilot sites. After the California additions, the platform will have expanded to 65 sites.

Dr. Whitcomb’s news was just one of the tidbits tossed out during the practice management pre-course, one of eight daylong courses for hospitalists. Two new pre-courses debuted this year: “Early Career Hospitalist: Skills for Success” and “Essential Neurology for the Hospitalist.”

“It’s a very good learning environment where you can sit down and focus,” said Julius Yang, MD, PhD, a hospitalist at Beth Israel Deaconess Medical Center in Boston and the course director for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) learning session. “It allows you to really immerse yourself in the information.”

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The Pediatric Hospital Medicine Core Competencies Supplement

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0

Pediatric Hospital Medicine Core Competencies Table of Contents
Introductionv
Authors, Reviewers, and Editorsvii
Section 1:Common Clinical Diagnoses and Conditions 
Acute abdominal pain and the acute abdomen1
Apparent life‐threatening event2
Asthma3
Bone and joint infections5
Bronchiolitis6
Central nervous system infections8
Diabetes mellitus9
Failure to thrive11
Fever of unknown origin13
Gastroenteritis14
Kawasaki disease16
Neonatal fever17
Neonatal jaundice18
Pneumonia19
Respiratory failure21
Seizures22
Shock24
Sickle cell disease25
Skin and soft tissue infection26
Toxic ingestion28
Upper airway infections29
Urinary tract infections31
Section 2:Core Skills 
Bladder catheterization/suprapubic bladder tap34
Electrocardiogram interpretation35
Feeding tubes36
Fluids and electrolyte management37
Intravenous access and phlebotomy39
Lumbar puncture40
Non‐invasive monitoring42
Nutrition43
Oxygen delivery and airway management44
Pain management46
Pediatric advanced life support47
Procedural sedation49
Radiographic interpretation50
Section 3:Specialized Clinical Services 
Child abuse and neglect53
Hospice and palliative care54
Leading a healthcare team55
Newborn care and delivery room management57
Technology dependent children59
Transport of the critically ill child60
Section 4:Healthcare Systems: Supporting and Advancing Child Health 
Advocacy64
Business practices65
Communication67
Continuous quality improvement68
Cost‐effective care69
Education71
Ethics72
Evidence based medicine73
Health information systems75
Legal issues/risk management76
Patient safety77
Research79
Transitions of care80
Appendix Original Research 
Pediatric Hospital Medicine Core Competencies: Development and Methodology Erin R. Stucky MD, Mary C. Ottolini MD, MPH and Jennifer Maniscalco MD, MPH82
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0

Pediatric Hospital Medicine Core Competencies Table of Contents
Introductionv
Authors, Reviewers, and Editorsvii
Section 1:Common Clinical Diagnoses and Conditions 
Acute abdominal pain and the acute abdomen1
Apparent life‐threatening event2
Asthma3
Bone and joint infections5
Bronchiolitis6
Central nervous system infections8
Diabetes mellitus9
Failure to thrive11
Fever of unknown origin13
Gastroenteritis14
Kawasaki disease16
Neonatal fever17
Neonatal jaundice18
Pneumonia19
Respiratory failure21
Seizures22
Shock24
Sickle cell disease25
Skin and soft tissue infection26
Toxic ingestion28
Upper airway infections29
Urinary tract infections31
Section 2:Core Skills 
Bladder catheterization/suprapubic bladder tap34
Electrocardiogram interpretation35
Feeding tubes36
Fluids and electrolyte management37
Intravenous access and phlebotomy39
Lumbar puncture40
Non‐invasive monitoring42
Nutrition43
Oxygen delivery and airway management44
Pain management46
Pediatric advanced life support47
Procedural sedation49
Radiographic interpretation50
Section 3:Specialized Clinical Services 
Child abuse and neglect53
Hospice and palliative care54
Leading a healthcare team55
Newborn care and delivery room management57
Technology dependent children59
Transport of the critically ill child60
Section 4:Healthcare Systems: Supporting and Advancing Child Health 
Advocacy64
Business practices65
Communication67
Continuous quality improvement68
Cost‐effective care69
Education71
Ethics72
Evidence based medicine73
Health information systems75
Legal issues/risk management76
Patient safety77
Research79
Transitions of care80
Appendix Original Research 
Pediatric Hospital Medicine Core Competencies: Development and Methodology Erin R. Stucky MD, Mary C. Ottolini MD, MPH and Jennifer Maniscalco MD, MPH82

0

Pediatric Hospital Medicine Core Competencies Table of Contents
Introductionv
Authors, Reviewers, and Editorsvii
Section 1:Common Clinical Diagnoses and Conditions 
Acute abdominal pain and the acute abdomen1
Apparent life‐threatening event2
Asthma3
Bone and joint infections5
Bronchiolitis6
Central nervous system infections8
Diabetes mellitus9
Failure to thrive11
Fever of unknown origin13
Gastroenteritis14
Kawasaki disease16
Neonatal fever17
Neonatal jaundice18
Pneumonia19
Respiratory failure21
Seizures22
Shock24
Sickle cell disease25
Skin and soft tissue infection26
Toxic ingestion28
Upper airway infections29
Urinary tract infections31
Section 2:Core Skills 
Bladder catheterization/suprapubic bladder tap34
Electrocardiogram interpretation35
Feeding tubes36
Fluids and electrolyte management37
Intravenous access and phlebotomy39
Lumbar puncture40
Non‐invasive monitoring42
Nutrition43
Oxygen delivery and airway management44
Pain management46
Pediatric advanced life support47
Procedural sedation49
Radiographic interpretation50
Section 3:Specialized Clinical Services 
Child abuse and neglect53
Hospice and palliative care54
Leading a healthcare team55
Newborn care and delivery room management57
Technology dependent children59
Transport of the critically ill child60
Section 4:Healthcare Systems: Supporting and Advancing Child Health 
Advocacy64
Business practices65
Communication67
Continuous quality improvement68
Cost‐effective care69
Education71
Ethics72
Evidence based medicine73
Health information systems75
Legal issues/risk management76
Patient safety77
Research79
Transitions of care80
Appendix Original Research 
Pediatric Hospital Medicine Core Competencies: Development and Methodology Erin R. Stucky MD, Mary C. Ottolini MD, MPH and Jennifer Maniscalco MD, MPH82
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New Knowledge Paramount to HM10 Attendees

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For an early-career hospitalist like Michele DeKorte, MD, HM10 offers a plethora of opportunities for practical knowledge and bushels of take-home points. “This is my first time, and I’m excited to be here,” Dr. DeKorte said moments after registering for HM10 at the Gaylord National Resort and Convention Center just outside Washington, D.C.

Dr. DeKorte, who has worked as a hospitalist at the University of California at San Diego since 2008, is one of a record 2,500 hospitalists registered for SHM’s annual meeting. She and hundreds of other hospitalists were taking part in Thursday’s lineup of pre-courses.

“I’m doing the procedures pre-course [Essential Procedures for the Hospitalist A Hands-on Experience] in the afternoon. I like procedures, so I think it will be fun,” she said, noting she will focus on the clinical track throughout the four-day event, which features more than 90 educational sessions. “It’s more interesting to me at this stage of the game. I want to have a better idea of how people are practicing HM around the country.”

Catherine Fitzgerald, DO, has worked as a hospitalist since 2005 and is attending her first annual meeting. For two years, she worked in an administrative role with CPMG at St. Joseph’s Memorial Hospital in Denver, and she plans to attend a smattering of practice-management sessions. “I also sit on our heart-failure committee at St. Joseph’s, so I have signed up for the session ‘How to Prevent Heart Failure Readmissions.’” she explained. “The meeting sessions are good reviews of things you already know, and interspersed in the discussions usually are these little pearls of new knowledge for your practice.”

In addition to aiming to improve her HM practice, Dr. Fitzgerald is excited to be in the nation’s capital with loved ones. Dr. Fitzgerald’s mother and 6-year-old son are scheduled to visit the White House.

“I’ll be at the conference all day, but that’s OK,” she said, with a hint of jealousy. “It was snowing in Denver, and we had to de-ice the plane last night. It’s 80 and sunny here, so this is beautiful.”

One of Dr. DeKorte’s colleagues at UCSD, Diana Childers, MD, was filling up the tank of knowledge in the “Documentation and Coding for Hospitalists” pre-course. Dr. Childers is one of the UCSD group’s billing experts, and Dr. DeKorte was looking forward to picking her brain.

“It’s still overwhelming to me,” Dr. DeKorte says. “I’m hoping she’ll pass along the nuggets, the gems of billing and coding.”

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For an early-career hospitalist like Michele DeKorte, MD, HM10 offers a plethora of opportunities for practical knowledge and bushels of take-home points. “This is my first time, and I’m excited to be here,” Dr. DeKorte said moments after registering for HM10 at the Gaylord National Resort and Convention Center just outside Washington, D.C.

Dr. DeKorte, who has worked as a hospitalist at the University of California at San Diego since 2008, is one of a record 2,500 hospitalists registered for SHM’s annual meeting. She and hundreds of other hospitalists were taking part in Thursday’s lineup of pre-courses.

“I’m doing the procedures pre-course [Essential Procedures for the Hospitalist A Hands-on Experience] in the afternoon. I like procedures, so I think it will be fun,” she said, noting she will focus on the clinical track throughout the four-day event, which features more than 90 educational sessions. “It’s more interesting to me at this stage of the game. I want to have a better idea of how people are practicing HM around the country.”

Catherine Fitzgerald, DO, has worked as a hospitalist since 2005 and is attending her first annual meeting. For two years, she worked in an administrative role with CPMG at St. Joseph’s Memorial Hospital in Denver, and she plans to attend a smattering of practice-management sessions. “I also sit on our heart-failure committee at St. Joseph’s, so I have signed up for the session ‘How to Prevent Heart Failure Readmissions.’” she explained. “The meeting sessions are good reviews of things you already know, and interspersed in the discussions usually are these little pearls of new knowledge for your practice.”

In addition to aiming to improve her HM practice, Dr. Fitzgerald is excited to be in the nation’s capital with loved ones. Dr. Fitzgerald’s mother and 6-year-old son are scheduled to visit the White House.

“I’ll be at the conference all day, but that’s OK,” she said, with a hint of jealousy. “It was snowing in Denver, and we had to de-ice the plane last night. It’s 80 and sunny here, so this is beautiful.”

One of Dr. DeKorte’s colleagues at UCSD, Diana Childers, MD, was filling up the tank of knowledge in the “Documentation and Coding for Hospitalists” pre-course. Dr. Childers is one of the UCSD group’s billing experts, and Dr. DeKorte was looking forward to picking her brain.

“It’s still overwhelming to me,” Dr. DeKorte says. “I’m hoping she’ll pass along the nuggets, the gems of billing and coding.”

For an early-career hospitalist like Michele DeKorte, MD, HM10 offers a plethora of opportunities for practical knowledge and bushels of take-home points. “This is my first time, and I’m excited to be here,” Dr. DeKorte said moments after registering for HM10 at the Gaylord National Resort and Convention Center just outside Washington, D.C.

Dr. DeKorte, who has worked as a hospitalist at the University of California at San Diego since 2008, is one of a record 2,500 hospitalists registered for SHM’s annual meeting. She and hundreds of other hospitalists were taking part in Thursday’s lineup of pre-courses.

“I’m doing the procedures pre-course [Essential Procedures for the Hospitalist A Hands-on Experience] in the afternoon. I like procedures, so I think it will be fun,” she said, noting she will focus on the clinical track throughout the four-day event, which features more than 90 educational sessions. “It’s more interesting to me at this stage of the game. I want to have a better idea of how people are practicing HM around the country.”

Catherine Fitzgerald, DO, has worked as a hospitalist since 2005 and is attending her first annual meeting. For two years, she worked in an administrative role with CPMG at St. Joseph’s Memorial Hospital in Denver, and she plans to attend a smattering of practice-management sessions. “I also sit on our heart-failure committee at St. Joseph’s, so I have signed up for the session ‘How to Prevent Heart Failure Readmissions.’” she explained. “The meeting sessions are good reviews of things you already know, and interspersed in the discussions usually are these little pearls of new knowledge for your practice.”

In addition to aiming to improve her HM practice, Dr. Fitzgerald is excited to be in the nation’s capital with loved ones. Dr. Fitzgerald’s mother and 6-year-old son are scheduled to visit the White House.

“I’ll be at the conference all day, but that’s OK,” she said, with a hint of jealousy. “It was snowing in Denver, and we had to de-ice the plane last night. It’s 80 and sunny here, so this is beautiful.”

One of Dr. DeKorte’s colleagues at UCSD, Diana Childers, MD, was filling up the tank of knowledge in the “Documentation and Coding for Hospitalists” pre-course. Dr. Childers is one of the UCSD group’s billing experts, and Dr. DeKorte was looking forward to picking her brain.

“It’s still overwhelming to me,” Dr. DeKorte says. “I’m hoping she’ll pass along the nuggets, the gems of billing and coding.”

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Evidence‐based medicine

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Introduction

Evidence‐based medicine (EBM) is the judicious use of systematically evaluated clinical research applied to care of a patient or population. Evidence‐based medicine principles support use of results from rigorously validated randomized controlled trials where available, in combination with other sources of information such as other published literature, expert opinion and consensus statements. Grading research based on a hierarchy of strength of evidence is a hallmark of EBM. Clinical decisions are then made considering a combination of a patient's value system, specific clinical circumstances, and a thorough assessment of the literature regarding the clinical condition. Used correctly, application of EBM results in use of current best scientific knowledge to create best plans of care while acknowledging the specific circumstance of patients.

Knowledge

Pediatric hospitalists should be able to:

  • Define EBM and state how its use is integrated into clinical decision‐making for a patient or a population.

  • Review how EBM support quality improvement and patient safety efforts.

  • List databases and other resources commonly used to search for medical evidence.

  • Discuss the risk and benefits of accessing medical resources through publicly available search engines.

  • Discuss the benefits and limitations of commonly used scientific medical resources, considering issues such as publication bias, consensus statement methodology used, national versus international web indexed articles, and others.

  • Explain the classification systems used to grade the strength of evidence in a given published work and discuss how this can help guide clinical decision making.

  • Explain how each of the components (PICO, or patient‐intervention‐control‐outcomes) of a well composed, searchable clinical question aid in obtaining a more accurate and comprehensive list of references.

  • Distinguish between different study designs, such as retrospective, prospective, case control, and others and list the benefits and limitations of each.

  • Compare and contrast the major study types such as cost‐effectiveness, therapy, diagnosis, prognosis, harm, and systematic review.

  • Define commonly used terms such as relative and absolute risk reduction, number needed to treat (NNT), sensitivity, specificity, positive and negative predictive values (PPV, NPV), likelihood ratios (LR).

 

Skills

Pediatric hospitalists should be able to:

  • Demonstrate facility with internet search engines to access all potentially relevant sources of information.

  • Access on line evidence‐based medicine toolkits to assist with the assessment of healthcare literature.

  • Translate a clinical question into a searchable PICO question or search string.

  • Identify the type of clinical question being asked: therapy, diagnosis, prognosis or harm/causality.

  • Identify the most appropriate study design for a given specific question.

  • Demonstrate proficiency in performance of an EBM literature search using electronic resources such as Pub Med.

  • Critically appraise the quality of studies, using a consistent method.

  • Critically interpret study results.

  • Apply relevant results of validated studies that are of the highest quality available to care for individual patients and populations.

  • Develop a personal strategy to consistently incorporate evidence, balance of harm and benefits, and patients' values into clinical decision making to deliver the highest quality care.

 

Attitudes

Pediatric hospitalists should be able to:

  • Seek the best available evidence to support clinical decision making.

  • Acquire and maintain EBM skills through integration into daily practice and pursuit of ongoing continuing education.

  • Recognize how personal practice patterns are influenced by the integration of EBM.

  • Role model use of EBM at the beside.

 

Systems Organization and Improvement

In order to improve efficiency and quality within their organizations, pediatric hospitalists should:

  • Lead, coordinate or participate in the development and implementation cost‐effective, evidence‐based care pathways to standardize the evaluation and management of hospitalized children in the local system.

  • Engage with hospital staff, subspecialists, and others in a multidisciplinary team approach toward integrating EBM into clinical decision making processes.

  • Work with hospital administrators to acquire and maintain effective, efficient electronic resources for the performance of EBM.

 

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Journal of Hospital Medicine - 5(2)
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98-99
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Introduction

Evidence‐based medicine (EBM) is the judicious use of systematically evaluated clinical research applied to care of a patient or population. Evidence‐based medicine principles support use of results from rigorously validated randomized controlled trials where available, in combination with other sources of information such as other published literature, expert opinion and consensus statements. Grading research based on a hierarchy of strength of evidence is a hallmark of EBM. Clinical decisions are then made considering a combination of a patient's value system, specific clinical circumstances, and a thorough assessment of the literature regarding the clinical condition. Used correctly, application of EBM results in use of current best scientific knowledge to create best plans of care while acknowledging the specific circumstance of patients.

Knowledge

Pediatric hospitalists should be able to:

  • Define EBM and state how its use is integrated into clinical decision‐making for a patient or a population.

  • Review how EBM support quality improvement and patient safety efforts.

  • List databases and other resources commonly used to search for medical evidence.

  • Discuss the risk and benefits of accessing medical resources through publicly available search engines.

  • Discuss the benefits and limitations of commonly used scientific medical resources, considering issues such as publication bias, consensus statement methodology used, national versus international web indexed articles, and others.

  • Explain the classification systems used to grade the strength of evidence in a given published work and discuss how this can help guide clinical decision making.

  • Explain how each of the components (PICO, or patient‐intervention‐control‐outcomes) of a well composed, searchable clinical question aid in obtaining a more accurate and comprehensive list of references.

  • Distinguish between different study designs, such as retrospective, prospective, case control, and others and list the benefits and limitations of each.

  • Compare and contrast the major study types such as cost‐effectiveness, therapy, diagnosis, prognosis, harm, and systematic review.

  • Define commonly used terms such as relative and absolute risk reduction, number needed to treat (NNT), sensitivity, specificity, positive and negative predictive values (PPV, NPV), likelihood ratios (LR).

 

Skills

Pediatric hospitalists should be able to:

  • Demonstrate facility with internet search engines to access all potentially relevant sources of information.

  • Access on line evidence‐based medicine toolkits to assist with the assessment of healthcare literature.

  • Translate a clinical question into a searchable PICO question or search string.

  • Identify the type of clinical question being asked: therapy, diagnosis, prognosis or harm/causality.

  • Identify the most appropriate study design for a given specific question.

  • Demonstrate proficiency in performance of an EBM literature search using electronic resources such as Pub Med.

  • Critically appraise the quality of studies, using a consistent method.

  • Critically interpret study results.

  • Apply relevant results of validated studies that are of the highest quality available to care for individual patients and populations.

  • Develop a personal strategy to consistently incorporate evidence, balance of harm and benefits, and patients' values into clinical decision making to deliver the highest quality care.

 

Attitudes

Pediatric hospitalists should be able to:

  • Seek the best available evidence to support clinical decision making.

  • Acquire and maintain EBM skills through integration into daily practice and pursuit of ongoing continuing education.

  • Recognize how personal practice patterns are influenced by the integration of EBM.

  • Role model use of EBM at the beside.

 

Systems Organization and Improvement

In order to improve efficiency and quality within their organizations, pediatric hospitalists should:

  • Lead, coordinate or participate in the development and implementation cost‐effective, evidence‐based care pathways to standardize the evaluation and management of hospitalized children in the local system.

  • Engage with hospital staff, subspecialists, and others in a multidisciplinary team approach toward integrating EBM into clinical decision making processes.

  • Work with hospital administrators to acquire and maintain effective, efficient electronic resources for the performance of EBM.

 

Introduction

Evidence‐based medicine (EBM) is the judicious use of systematically evaluated clinical research applied to care of a patient or population. Evidence‐based medicine principles support use of results from rigorously validated randomized controlled trials where available, in combination with other sources of information such as other published literature, expert opinion and consensus statements. Grading research based on a hierarchy of strength of evidence is a hallmark of EBM. Clinical decisions are then made considering a combination of a patient's value system, specific clinical circumstances, and a thorough assessment of the literature regarding the clinical condition. Used correctly, application of EBM results in use of current best scientific knowledge to create best plans of care while acknowledging the specific circumstance of patients.

Knowledge

Pediatric hospitalists should be able to:

  • Define EBM and state how its use is integrated into clinical decision‐making for a patient or a population.

  • Review how EBM support quality improvement and patient safety efforts.

  • List databases and other resources commonly used to search for medical evidence.

  • Discuss the risk and benefits of accessing medical resources through publicly available search engines.

  • Discuss the benefits and limitations of commonly used scientific medical resources, considering issues such as publication bias, consensus statement methodology used, national versus international web indexed articles, and others.

  • Explain the classification systems used to grade the strength of evidence in a given published work and discuss how this can help guide clinical decision making.

  • Explain how each of the components (PICO, or patient‐intervention‐control‐outcomes) of a well composed, searchable clinical question aid in obtaining a more accurate and comprehensive list of references.

  • Distinguish between different study designs, such as retrospective, prospective, case control, and others and list the benefits and limitations of each.

  • Compare and contrast the major study types such as cost‐effectiveness, therapy, diagnosis, prognosis, harm, and systematic review.

  • Define commonly used terms such as relative and absolute risk reduction, number needed to treat (NNT), sensitivity, specificity, positive and negative predictive values (PPV, NPV), likelihood ratios (LR).

 

Skills

Pediatric hospitalists should be able to:

  • Demonstrate facility with internet search engines to access all potentially relevant sources of information.

  • Access on line evidence‐based medicine toolkits to assist with the assessment of healthcare literature.

  • Translate a clinical question into a searchable PICO question or search string.

  • Identify the type of clinical question being asked: therapy, diagnosis, prognosis or harm/causality.

  • Identify the most appropriate study design for a given specific question.

  • Demonstrate proficiency in performance of an EBM literature search using electronic resources such as Pub Med.

  • Critically appraise the quality of studies, using a consistent method.

  • Critically interpret study results.

  • Apply relevant results of validated studies that are of the highest quality available to care for individual patients and populations.

  • Develop a personal strategy to consistently incorporate evidence, balance of harm and benefits, and patients' values into clinical decision making to deliver the highest quality care.

 

Attitudes

Pediatric hospitalists should be able to:

  • Seek the best available evidence to support clinical decision making.

  • Acquire and maintain EBM skills through integration into daily practice and pursuit of ongoing continuing education.

  • Recognize how personal practice patterns are influenced by the integration of EBM.

  • Role model use of EBM at the beside.

 

Systems Organization and Improvement

In order to improve efficiency and quality within their organizations, pediatric hospitalists should:

  • Lead, coordinate or participate in the development and implementation cost‐effective, evidence‐based care pathways to standardize the evaluation and management of hospitalized children in the local system.

  • Engage with hospital staff, subspecialists, and others in a multidisciplinary team approach toward integrating EBM into clinical decision making processes.

  • Work with hospital administrators to acquire and maintain effective, efficient electronic resources for the performance of EBM.

 

Issue
Journal of Hospital Medicine - 5(2)
Issue
Journal of Hospital Medicine - 5(2)
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98-99
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Rishi Agrawal, MD, MPH

Pediatric Hospitalist, Children's Memorial Hospital and LaRabida Children's Hospital

Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine

Chicago, IL

Feeding Tubes

Brian Alverson, MD

Head, Pediatric Hospitalist Section, Hasbro Children's Hospital

Assistant Professor of Pediatrics, Warren Alpert School of Medicine at Brown University

Providence, RI

Neonatal Fever

Pneumonia

Allison Ballantine, MD

Medical Director of the Integrated Care Service, Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Technology Dependent Children

Julia Beauchamp‐Walters, MD

Pediatric Emergency Transport Coordinator, CSSD, RCHHC Pediatric Emergency Transports, Rady Childrens Hospital

Clinical Instructor of Pediatrics, University of California, San Diego

San Diego, CA

Transport of the Critically Ill Child

Glenn F. Billman, MD

Medical Safety and Regulatory Officer, Rady Children's Hospital

San Diego, CA

Patient Safety

April O. Buchanan, MD, FAAP

Vice Chair of Quality, Department of Pediatrics, Children's Hospital at Greenville Hospital System University Medical Center

Assistant Professor of Clinical Pediatrics, University of South Carolina School of Medicine

Greenville, SC

Shock

Douglas W. Carlson, MD

Chief, Pediatric Hospital Medicine, St. Louis Children's Hospital

Associate Professor of Pediatrics, Washington University

St. Louis, MO

Procedural Sedation

Technology Dependent Children

Vincent W. Chiang, MD

Chief, Inpatient Services, Department of Medicine, Children's Hospital Boston

Associate Professor of Pediatrics, Harvard Medical School

Boston, MA

Seizures

Michael R. Clemmens, MD

Director Pediatric Hospitalist Program, Anne Arundel Medical Center

Assistant Clinical Professor of Pediatrics, The George Washington University School of Medicine

Annapolis, MD

Acute Abdominal Pain and The Acute Abdomen

Jamie L. Clute, MD, FAAP, FHM

Medical Director, Inpatient Services, Joe Dimaggio Children's Hospital

Clinical Assistant Professor, NOVA Southeastern University, College of Osteopathic Medicine and Assistant Affiliate Professor, Barry University

Hollywood, FL

Kawasaki Disease

Shannon Connor Phillips, MD, MPH

Patient Safety Officer, Quality and Patient Safety Institute, Cleveland Clinic

Assistant Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University

Cleveland, OH

Evidence Based Medicine

Tanya Dansky, MD

Medical Director, Children's Physicians Medical GroupMedical Director, San Diego Hospice and The Institute For Palliative Medicine, Rady Children's Hospital

Assistant Clinical Professor of Pediatrics, University of California, San Diego

San Diego, CA

Hospice and Palliative Care, Ethics

Jennifer Daru, MD, FAAP, FHM

Chief, Pediatric Hospitalist Division; Interim Chief, Pediatric and Neonatal Transport, California Pacific Medical Center

Clinical Assistant Professor (pending), University of California San Francisco

San Francisco, CA

Leading a Healthcare Team

Newborn Care and Delivery Room Management

Yasmeen N. Daud, MD

Director of Pediatric Hospitalist Sedation in the Pediatric Acute Wound Service and Director of the Pediatric Hospitalist After Hours Sedation Program, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Oxygen Delivery and Airway Management

Craig DeWolfe, MD, MEd

Pediatric Hospitalist, Children's National Medical Center

Assistant Professor of Pediatrics, George Washington School of Medicine and Health Sciences

Washington DC

Apparent Life‐Threatening Event

Joseph M. Geskey, DO

Division Chief, Pediatric Hospital Medicine, Medical Director of Hospital Care Management, Penn State Hershey Children's Hospital

Associate Professor of Pediatrics, Penn State M. S. Hershey Medical Center

Hershey, PA

Pneumonia

Upper Airway Infections

Bronchiolitis

Paul D. Hain, MD

Associate Chief of Staff, Monroe Carell Jr. Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics, Vanderbilt University

Nashville, TN

Health Information Systems

Keith Herzog, MD

Pediatric Hospitalist, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Central Nervous System Infections

Margaret Hood, MD, FAAP

Pediatric Hospitalist, Seattle Children's Hospital

Clinical Associate Professor of Pediatrics, University of Washington

Seattle, WA

Diabetes Mellitus

Hospice and Palliative Care

Kevin B. Johnson, MD, MS

Vice Chair of Biomedical Informatics, Vanderbilt University Medical Center

Associate Professor of Medical Informatics and Pediatrics, Vanderbilt University Medical Center

Nashville, TN

Health Information Systems

Rick Johnson, MD, FAAP

Division Head, Regional Pediatrics, CCMC, and American Heart Association Regional and National PALS Faculty, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Pediatric Advanced Life Support

Brian Kelly, MD, MRCP (UK), FAAP

Pediatric Hospitalist, Ranken Jordan Pediatric Rehabilitative Hospital, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Bladder Catheterization/Suprapubic Bladder Tap

Herbert C Kimmons, MD, MMM

President Children's Specialists of San Diego (Medical Quality Officer of Rady Children's Hospital of San Diego, 20062008), Children's Specialists of San Diego in California

Professor of Pediatrics, University of California San Diego

San Diego, CA

Continuous Quality Improvement

Patient Safety

Su‐Ting T. Li, MD, MPH

Associate Pediatric Residency Program Director, University of California, Davis

Assistant Professor of Pediatrics, University of California, Davis

Sacramento, CA

Skin and Soft Tissue Infections

Patricia S. Lye, MD

Medical Director, Hospitalists, Children's Hospital of Wisconsin

Associate Professor of Pediatrics, Medical College of Wisconsin

Milwaukee, WI

Transitions of Care

Jennifer Maniscalco, MD, MPH, FAAP

Director of Education, Division of Pediatric Hospital Medicine, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Failure to Thrive

Transitions of Care

Nutrition

David E. Marcello III, MD, FAAP

Pediatric Hospitalist, Connecticut Children's Medical Center

Assistant Professor in Pediatrics, University of Connecticut Medical School

Hartford, CT

Lumbar Puncture

Intravenous Access and Phlebotomy

Sanford M. Melzer, MD, MBA

Senior Vice President, Strategic Planning and Business Development, Seattle Children's Hospital

Professor of Pediatrics, University of Washington School of Medicine

Seattle, WA

Cost Effective Care

Margaret I. Mikula, MD

Pediatric Hospitalist, Penn State Hershey Children's Hospital

Assistant Professor of Pediatrics, Penn State M. S. Hershey Medical Center

Hershey, PA

Pneumonia

Bronchiolitis

Laura J Mirkinson, MD, FAAP

Director of Pediatrics, Blythedale Children's Hospital

Valhalla, NY

Neonatal Jaundice

Christopher D. Miller, MD, FAAP

Pediatric Hospitalist and Allergist, Children's Mercy Hospitals and Clinics

Assistant Professor of Pediatrics, University of Missouri‐Kansas City School of Medicine

Kansas City, MO

Asthma

Christopher O'Hara, MD, FACP

St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia PA

Pain Management

Mary C. Ottolini MD, MPH, FAAP, FHM

Chair, Academic Pediatric Association Education Committee Immediate Past Hospitalist Division Chief; Vice Chair for Medical Education, Children's National Medical Center

Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Fluid and Electrolyte Management

Gastroenteritis

Education

Brian M. Pate, MD, FAAP, FHM

Section Chief, Pediatric Hospital Medicine, Vice Chairman, Inpatient Services, Children's Mercy Hospital and Clinics

Assistant Professor of Pediatrics, University of Missouri‐Kansas City School of Medicine

Business Practices

Asthma

Dana Patrick, RN, BSN

Transport Program Manager NICU\PICU, Rady Children's Hospital

San Diego, CA

Transport of the Critically Ill Child

Jack M. Percelay, MD, MPH, FAAP, FHM

Society of Hospital Medicine, Pediatric Board Member; Immediate Past‐Chair, AAP Section on Hospital Medicine, E.L.M.O. Pediatrics

Associate Professor, Pace University Physician Assistant Program

New York, New York

Advocacy

David Pressel, MD, PhD, FHM, FAAP

Director, General Pediatrics Inpatient Services, A.I. duPont Hospital for Children

Assistant Professor of Pediatrics, Jefferson Medical College, Thomas Jefferson University

Wilmington, DE

Child Abuse and Neglect

Kris P Rehm, MD

Director, Division of Hospital Medicine, Monroe Carell Jr Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics, Vanderbilt University

Nashville, TN

Respiratory Failure

Kyung E. Rhee, MD, MSc

Pediatric Hospitalist, Hasbro Children's Hospital and The Weight Control and Diabetes Research Center

Assistant Professor of Pediatrics, Warren Alpert Medical School of Brown University

Providence, RI

Fever of Unknown Origin

Mark F Riederer, MD

Pediatric Hospitalist, Monroe Carell Jr Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics,

Nashville, TN

Respiratory Failure

Michael Ruhlen, MD, MHCM, FAAP, FHM, FACHE

Vice President and Chief Medical Officer, Carolinas Medical Center Mercy

Carolinas Medical Center Pineville

Charlotte, NC

Legal Issues/Risk Management

Henry M. Seidel, MD

Professor Emeritus, Johns Hopkins Berman Institute of Bioethics

Professor Emeritus of Pediatrics, The Johns Hopkins University School of Medicine

Baltimore, MD

Communication

Anand Sekaran, MD

Medical Director, Inpatient Services, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Radiographic Interpretation

Kristin A. Shadman, MD, FAAP

Pediatric Hospitalist

Oxygen Delivery and Airway Management

Vipul Singla, MD, FAAP

Site Leader, Lake Forest Hospital (Children's Memorial Medical Group)

Instructor in Pediatrics, Northwestern University Feinberg School of Medicine

Chicago, IL

Electrocardiogram Interpretation

Karen Smith, MD, MEd

Chief Medical Officer, The HSC Pediatric Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Apparent Life‐Threatening Event

Jeffrey L. Sperring, MD

Chief Medical Officer, Riley Hospital for Children

Assistant Professor of Pediatrics, Indiana University School of Medicine

Indianapolis, IN

Bone and Joint Infections

Glenn Stryjewski, MD, MPH

Associate Residency Program Director, AI duPont Hospital for Children

Assistant professor of Pediatrics, Jefferson Medical College, Thomas Jefferson University

Wilmington, DE

Toxic Ingestion

Erin R. Stucky, MD, FAAP, FHM

Director of Graduate Medical Education, Rady Children's Hospital San Diego; Medical Director of Quality Improvement, Rady Children's Hospital San Diego; Associate Program Director, UCSD Pediatric Residency Program; Vice Chair for Clinical Affairs, UCSD Department of Pediatrics; Director, Pediatric Hospital Medicine Fellowship, Rady Children's Hospital

Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Evidence Based Medicine

Continuous Quality Improvement

Technology Dependent Children

E. Douglas Thompson, Jr., MD

Director, Pediatric Generalist Service, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Sickle Cell Disease

Michael Turmelle, MD

Pediatric Hospitalist, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Non‐Invasive Monitoring

Macdara G. Tynan, MD, MBA, FAAP

Associate Director of Inpatient Pediatrics, Levine Children's Hospital

Charlotte, NC

Diabetes Mellitus

Toxic Ingestion

Ronald J. Williams, MD

Pediatric Hospitalist, Penn State Hershey Children's Hospital

Associate Professor of Pediatrics and Medicine, Penn State M. S. Hershey Medical Center

Hershey, PA

Upper Airway Infections

Heidi Wolf MD, FAAP

Director Pediatric Hospitalist Program, Johns Hopkins

Assistant Clinical Professor, John Hopkins University

Baltimore, MD

Fever of Unknown Origin

Neonatal Fever

Susan Wu, MD

Pediatric Hospitalist, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Bronchiolitis

Lisa B. Zaoutis, MD

Section Chief of Inpatient Services, Division of General Pediatrics, The Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Urinary Tract Infections

William T. Zempsky, MD

Associate Director; Division of Pain Medicine; Department of Pediatrics, Associate Director, Pain Relief Program, Connecticut Children's Medical Center

Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Pain Management

Reviewers

Allison Ballantine, MD

Medical Director of the Integrated Care Service, Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Technology Dependent Children

Margaret Hood, MD, FAAP

Pediatric Hospitalist, Seattle Children's Hospital

Clinical Associate Professor of Pediatrics, University of Washington

Seattle, WA

Hospice and Palliative Care

Ethics

Brian Kit, MD, MPH

Anne Arundel Medical Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Annapolis, MD

Advocacy

Evelina M. Krieger, MD

Children's National Medical Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Washington, DC

Advocacy

Cynthia L. Kuelbs, MD

Medical Director, Chadwick Center for Child Abuse; Division Director Pediatric Hospital Medicine, Rady Children's Hospital

Associate Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Child Abuse and Neglect

Christopher P. Landrigan, MD, MPH

Division Director, Pediatrics and Hospital Medicine; Research and Fellowship Director, Children's Hospital Boston Inpatient Pediatrics Service; Director, Sleep and Patient Safety Program at the Brigham and Women's Hospital, Children's Hospital Boston

Assistant Professor of Pediatrics and Medicine, Harvard Medical School

Boston, MA

Research

Michael Ruhlen, MD, MHCM, FAAP, FHM, FACHE

Vice President and Chief Medical Officer, Carolinas Medical Center Mercy

Carolinas Medical Center Pineville

Charlotte, NC

Legal Issues/Risk Management

Samir S. Shah, MD, MSCE

Senior Scholar, Center for Clinical Epidemiology and Biostatistics, The Children's Hospital of Philadelphia

Assistant Professor, Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine

Philadelphia, PA

Research

Rajendu Srivastava, MD, FRCP(C), MPH

Director of Pediatric Research in the Inpatient Setting (PRIS) Network, Primary Children's Medical Center, Intermountain Healthcare Inc.

Associate Professor, Division of Inpatient Medicine, Department of Pediatrics, University of Utah Health Sciences Center

Salt Lake City, UT

Research

Ben Bauer, MD, FAAP

Pediatric Hospital Medicine; Fellowship Director, Riley Children's Hospital, Indiana University School of Medicine

Indianapolis, IN

John Combes, MD

President/COO, Center for Healthcare Governance, American Hospital Association (AHA)

Washington, DC

Jennifer Daru, MD, FAAP, FHM

Chair‐elect AAP; Section on Hospital Medicine, American Academy of Pediatrics

San Francisco, CA

Jerrold Eichner, MD, FAAP

Chair, AAP National Committee on Hospital Care, American Academy of Pediatrics

Great Falls, MT

Rosemarie Faber, MSN/ED, RN, CCRN

Clinical Practice Specialist, American Association of Critical Care Nurses

Aliso Viejo, CA

Rani S Gereige, MD, MPH, FAAP

Director of Medical Education, Miami Children's Hospital

Miami, FL

David Jaimovich, MD, FAAP

President, QRI (Former Chief Medical Officer and Vice President for International Accreditation Services for Joint Commission Resources (JCR) and Joint Commission International (JCI)), Quality Resources International

Andrea Kline RN, MS, CPNP‐AC, CCRN, FCCM

Executive Board; Professional Issues; Pediatric Critical Care NP, National Association of Pediatric Nurse Practitioners (NAPNAP)

Cherry Hill, NJ

David D. Lloyd, MD, FRCP(C), FAAP

Section Chief of General Pediatrics Children's Healthcare of Atlanta, Director of Undergraduate Pediatric Education, Director of the Pediatric Hospitalist Fellowship, Children's Healthcare of Atlanta, Emory University School of Medicine

Atlanta, GA

Patricia S. Lye, MD, FAAP

AAP Section on Hospital Medicine, American Academy of Pediatrics

Milwaukee, WI

Sanjay Mahant, MD, FRCPC

Pediatric Hospital Medicine Fellowship Director, Hospital for Sick Children, University of Toronto School of Medicine

Toronto, Canada

Jennifer Maniscalco, MD, MPH, FAAP

Pediatric Hospital Medicine Fellowship Director, Children's Hospital Los Angeles

University of Southern California School of Medicine

Marlene Miller, MD, MSc, FAAP

Vice President for Quality, National Association of Children's Hospitals and Related Institutions (NACHRI)

Alexandria, VA

Paul E. Manicone, MD, FAAP

Associate Division Chief; Division of Hospitalist Medicine; Immediate past Fellowship Director, Children's National Medical Center, George Washington University School of Medicine

Washington DC

Warren Newton, MD

American Board of Family Medicine Board of Directors: Research and Development, IT, and Communications/publications Committees; Executive Associate Dean for Medical Education and William B. Aycock Distinguished Professor and Chair, Department of Family Medicine at the University of North Carolina at Chapel Hill, American Board of Family Medicine

Lexington, KY

Daniel Rauch, MD, FAAP, FHM

Chair, AAP Section on Hospital Medicine; Immediate Past Chair, Academic Pediatric Association Hospital Medicine Special Interest Group

AAP and APA

Ellen Schwalenstocker, PhD, MBA

Quality, Advocacy and Measurement, NACHRI

Alexandria, VA

Mary Jean Schuman, MSN, MBA, RN, CPNP

Chief Programs Officer, American Nursing Association

Silver Spring, MD

Neha H. Shah, MD, FAAP

Fellowship Director, Pediatric Hospital Medicine, Children's National Medical Center

George Washington University School of Medicine

Washington, DC

Geeta Singhal, MD, FAAP

Director, Pediatric Hospital Medicine Fellowship; Director, Faculty Inpatient Service; Co‐Director, PEM Faculty Development Program, Texas Children's Hospital, Baylor College of Medicine

Houston, TX

Jeffrey L. Sperring, MD, FAAP

Chair, Academic Pediatric Association Hospital Medicine Special Interest Group

Chief Medical Officer, Academic Pediatric Association

Indianapolis, IN

Erin R. Stucky, MD, FAAP, FHM

Pediatric Hospital Medicine, Fellowship Director, Rady Children's Hospital San Diego

University of California San Diego School of Medicine

San Diego, CA

Editors

Michael G. Burke, MD, MBA

Chairman of Pediatrics, Saint Agnes Hospital

Assistant Professor of Pediatrics, The Johns Hopkins University School of Medicine

Baltimore, MD

Douglas W. Carlson, MD

Chief, Pediatric Hospital Medicine, St. Louis Children's Hospital

Associate Professor of Pediatrics, Washington University

St. Louis, MO

Timothy T. Cornell, MD

C. S. Mott Women and Children's Hospital

Assistant Professor in the Department of Pediatrics and Communicable Diseases, University of Michigan

Ann Arbor, MI

Jack M. Percelay, MD, MPH, FAAP, FHM

Society of Hospital Medicine, Pediatric Board Member; Immediate Past‐Chair, AAP Section on Hospital Medicine, E.L.M.O. Pediatrics

Associate Professor, Pace University Physician Assistant Program

New York, New York

Daniel Rauch, MD, FAAP, FHM

Associate Director of Pediatrics, Elmhurst Hospital

New York

Anand Sekaran, MD

Medical Director, Inpatient Services, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

E. Douglas Thompson, Jr., MD

Director, Pediatric Generalist Service, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Heidi Wolf MD, FAAP

Director Pediatric Hospitalist Program, Johns Hopkins

Assistant Clinical Professor, John Hopkins University

Baltimore, MD

David Zipes, MD FAAP, FHM

Director, St. Vincent Pediatric Hospitalists, Peyton Manning Children's Hospital at St. Vincent

Indianapolis, IN

Senior Editors

Jennifer Maniscalco, MD, MPH, FAAP

Director of Education, Division of Pediatric Hospital Medicine, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Mary C. Ottolini MD, MPH, FAAP, FHM

Chair, Academic Pediatric Association Education Committee Immediate Past Hospitalist Division Chief; Vice Chair for Medical Education, Children's National Medical Center

Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Erin R. Stucky, MD, FAAP, FHM

Director of Graduate Medical Education, Rady Children's Hospital San Diego; Medical Director of Quality Improvement, Rady Children's Hospital San Diego; Associate Program Director, UCSD Pediatric Residency Program; Vice Chair for Clinical Affairs, UCSD Department of Pediatrics; Director, Pediatric Hospital Medicine Fellowship, Rady Children's Hospital

Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Article PDF
Issue
Journal of Hospital Medicine - 5(2)
Page Number
vii-xv
Sections
Article PDF
Article PDF

Rishi Agrawal, MD, MPH

Pediatric Hospitalist, Children's Memorial Hospital and LaRabida Children's Hospital

Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine

Chicago, IL

Feeding Tubes

Brian Alverson, MD

Head, Pediatric Hospitalist Section, Hasbro Children's Hospital

Assistant Professor of Pediatrics, Warren Alpert School of Medicine at Brown University

Providence, RI

Neonatal Fever

Pneumonia

Allison Ballantine, MD

Medical Director of the Integrated Care Service, Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Technology Dependent Children

Julia Beauchamp‐Walters, MD

Pediatric Emergency Transport Coordinator, CSSD, RCHHC Pediatric Emergency Transports, Rady Childrens Hospital

Clinical Instructor of Pediatrics, University of California, San Diego

San Diego, CA

Transport of the Critically Ill Child

Glenn F. Billman, MD

Medical Safety and Regulatory Officer, Rady Children's Hospital

San Diego, CA

Patient Safety

April O. Buchanan, MD, FAAP

Vice Chair of Quality, Department of Pediatrics, Children's Hospital at Greenville Hospital System University Medical Center

Assistant Professor of Clinical Pediatrics, University of South Carolina School of Medicine

Greenville, SC

Shock

Douglas W. Carlson, MD

Chief, Pediatric Hospital Medicine, St. Louis Children's Hospital

Associate Professor of Pediatrics, Washington University

St. Louis, MO

Procedural Sedation

Technology Dependent Children

Vincent W. Chiang, MD

Chief, Inpatient Services, Department of Medicine, Children's Hospital Boston

Associate Professor of Pediatrics, Harvard Medical School

Boston, MA

Seizures

Michael R. Clemmens, MD

Director Pediatric Hospitalist Program, Anne Arundel Medical Center

Assistant Clinical Professor of Pediatrics, The George Washington University School of Medicine

Annapolis, MD

Acute Abdominal Pain and The Acute Abdomen

Jamie L. Clute, MD, FAAP, FHM

Medical Director, Inpatient Services, Joe Dimaggio Children's Hospital

Clinical Assistant Professor, NOVA Southeastern University, College of Osteopathic Medicine and Assistant Affiliate Professor, Barry University

Hollywood, FL

Kawasaki Disease

Shannon Connor Phillips, MD, MPH

Patient Safety Officer, Quality and Patient Safety Institute, Cleveland Clinic

Assistant Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University

Cleveland, OH

Evidence Based Medicine

Tanya Dansky, MD

Medical Director, Children's Physicians Medical GroupMedical Director, San Diego Hospice and The Institute For Palliative Medicine, Rady Children's Hospital

Assistant Clinical Professor of Pediatrics, University of California, San Diego

San Diego, CA

Hospice and Palliative Care, Ethics

Jennifer Daru, MD, FAAP, FHM

Chief, Pediatric Hospitalist Division; Interim Chief, Pediatric and Neonatal Transport, California Pacific Medical Center

Clinical Assistant Professor (pending), University of California San Francisco

San Francisco, CA

Leading a Healthcare Team

Newborn Care and Delivery Room Management

Yasmeen N. Daud, MD

Director of Pediatric Hospitalist Sedation in the Pediatric Acute Wound Service and Director of the Pediatric Hospitalist After Hours Sedation Program, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Oxygen Delivery and Airway Management

Craig DeWolfe, MD, MEd

Pediatric Hospitalist, Children's National Medical Center

Assistant Professor of Pediatrics, George Washington School of Medicine and Health Sciences

Washington DC

Apparent Life‐Threatening Event

Joseph M. Geskey, DO

Division Chief, Pediatric Hospital Medicine, Medical Director of Hospital Care Management, Penn State Hershey Children's Hospital

Associate Professor of Pediatrics, Penn State M. S. Hershey Medical Center

Hershey, PA

Pneumonia

Upper Airway Infections

Bronchiolitis

Paul D. Hain, MD

Associate Chief of Staff, Monroe Carell Jr. Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics, Vanderbilt University

Nashville, TN

Health Information Systems

Keith Herzog, MD

Pediatric Hospitalist, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Central Nervous System Infections

Margaret Hood, MD, FAAP

Pediatric Hospitalist, Seattle Children's Hospital

Clinical Associate Professor of Pediatrics, University of Washington

Seattle, WA

Diabetes Mellitus

Hospice and Palliative Care

Kevin B. Johnson, MD, MS

Vice Chair of Biomedical Informatics, Vanderbilt University Medical Center

Associate Professor of Medical Informatics and Pediatrics, Vanderbilt University Medical Center

Nashville, TN

Health Information Systems

Rick Johnson, MD, FAAP

Division Head, Regional Pediatrics, CCMC, and American Heart Association Regional and National PALS Faculty, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Pediatric Advanced Life Support

Brian Kelly, MD, MRCP (UK), FAAP

Pediatric Hospitalist, Ranken Jordan Pediatric Rehabilitative Hospital, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Bladder Catheterization/Suprapubic Bladder Tap

Herbert C Kimmons, MD, MMM

President Children's Specialists of San Diego (Medical Quality Officer of Rady Children's Hospital of San Diego, 20062008), Children's Specialists of San Diego in California

Professor of Pediatrics, University of California San Diego

San Diego, CA

Continuous Quality Improvement

Patient Safety

Su‐Ting T. Li, MD, MPH

Associate Pediatric Residency Program Director, University of California, Davis

Assistant Professor of Pediatrics, University of California, Davis

Sacramento, CA

Skin and Soft Tissue Infections

Patricia S. Lye, MD

Medical Director, Hospitalists, Children's Hospital of Wisconsin

Associate Professor of Pediatrics, Medical College of Wisconsin

Milwaukee, WI

Transitions of Care

Jennifer Maniscalco, MD, MPH, FAAP

Director of Education, Division of Pediatric Hospital Medicine, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Failure to Thrive

Transitions of Care

Nutrition

David E. Marcello III, MD, FAAP

Pediatric Hospitalist, Connecticut Children's Medical Center

Assistant Professor in Pediatrics, University of Connecticut Medical School

Hartford, CT

Lumbar Puncture

Intravenous Access and Phlebotomy

Sanford M. Melzer, MD, MBA

Senior Vice President, Strategic Planning and Business Development, Seattle Children's Hospital

Professor of Pediatrics, University of Washington School of Medicine

Seattle, WA

Cost Effective Care

Margaret I. Mikula, MD

Pediatric Hospitalist, Penn State Hershey Children's Hospital

Assistant Professor of Pediatrics, Penn State M. S. Hershey Medical Center

Hershey, PA

Pneumonia

Bronchiolitis

Laura J Mirkinson, MD, FAAP

Director of Pediatrics, Blythedale Children's Hospital

Valhalla, NY

Neonatal Jaundice

Christopher D. Miller, MD, FAAP

Pediatric Hospitalist and Allergist, Children's Mercy Hospitals and Clinics

Assistant Professor of Pediatrics, University of Missouri‐Kansas City School of Medicine

Kansas City, MO

Asthma

Christopher O'Hara, MD, FACP

St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia PA

Pain Management

Mary C. Ottolini MD, MPH, FAAP, FHM

Chair, Academic Pediatric Association Education Committee Immediate Past Hospitalist Division Chief; Vice Chair for Medical Education, Children's National Medical Center

Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Fluid and Electrolyte Management

Gastroenteritis

Education

Brian M. Pate, MD, FAAP, FHM

Section Chief, Pediatric Hospital Medicine, Vice Chairman, Inpatient Services, Children's Mercy Hospital and Clinics

Assistant Professor of Pediatrics, University of Missouri‐Kansas City School of Medicine

Business Practices

Asthma

Dana Patrick, RN, BSN

Transport Program Manager NICU\PICU, Rady Children's Hospital

San Diego, CA

Transport of the Critically Ill Child

Jack M. Percelay, MD, MPH, FAAP, FHM

Society of Hospital Medicine, Pediatric Board Member; Immediate Past‐Chair, AAP Section on Hospital Medicine, E.L.M.O. Pediatrics

Associate Professor, Pace University Physician Assistant Program

New York, New York

Advocacy

David Pressel, MD, PhD, FHM, FAAP

Director, General Pediatrics Inpatient Services, A.I. duPont Hospital for Children

Assistant Professor of Pediatrics, Jefferson Medical College, Thomas Jefferson University

Wilmington, DE

Child Abuse and Neglect

Kris P Rehm, MD

Director, Division of Hospital Medicine, Monroe Carell Jr Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics, Vanderbilt University

Nashville, TN

Respiratory Failure

Kyung E. Rhee, MD, MSc

Pediatric Hospitalist, Hasbro Children's Hospital and The Weight Control and Diabetes Research Center

Assistant Professor of Pediatrics, Warren Alpert Medical School of Brown University

Providence, RI

Fever of Unknown Origin

Mark F Riederer, MD

Pediatric Hospitalist, Monroe Carell Jr Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics,

Nashville, TN

Respiratory Failure

Michael Ruhlen, MD, MHCM, FAAP, FHM, FACHE

Vice President and Chief Medical Officer, Carolinas Medical Center Mercy

Carolinas Medical Center Pineville

Charlotte, NC

Legal Issues/Risk Management

Henry M. Seidel, MD

Professor Emeritus, Johns Hopkins Berman Institute of Bioethics

Professor Emeritus of Pediatrics, The Johns Hopkins University School of Medicine

Baltimore, MD

Communication

Anand Sekaran, MD

Medical Director, Inpatient Services, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Radiographic Interpretation

Kristin A. Shadman, MD, FAAP

Pediatric Hospitalist

Oxygen Delivery and Airway Management

Vipul Singla, MD, FAAP

Site Leader, Lake Forest Hospital (Children's Memorial Medical Group)

Instructor in Pediatrics, Northwestern University Feinberg School of Medicine

Chicago, IL

Electrocardiogram Interpretation

Karen Smith, MD, MEd

Chief Medical Officer, The HSC Pediatric Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Apparent Life‐Threatening Event

Jeffrey L. Sperring, MD

Chief Medical Officer, Riley Hospital for Children

Assistant Professor of Pediatrics, Indiana University School of Medicine

Indianapolis, IN

Bone and Joint Infections

Glenn Stryjewski, MD, MPH

Associate Residency Program Director, AI duPont Hospital for Children

Assistant professor of Pediatrics, Jefferson Medical College, Thomas Jefferson University

Wilmington, DE

Toxic Ingestion

Erin R. Stucky, MD, FAAP, FHM

Director of Graduate Medical Education, Rady Children's Hospital San Diego; Medical Director of Quality Improvement, Rady Children's Hospital San Diego; Associate Program Director, UCSD Pediatric Residency Program; Vice Chair for Clinical Affairs, UCSD Department of Pediatrics; Director, Pediatric Hospital Medicine Fellowship, Rady Children's Hospital

Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Evidence Based Medicine

Continuous Quality Improvement

Technology Dependent Children

E. Douglas Thompson, Jr., MD

Director, Pediatric Generalist Service, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Sickle Cell Disease

Michael Turmelle, MD

Pediatric Hospitalist, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Non‐Invasive Monitoring

Macdara G. Tynan, MD, MBA, FAAP

Associate Director of Inpatient Pediatrics, Levine Children's Hospital

Charlotte, NC

Diabetes Mellitus

Toxic Ingestion

Ronald J. Williams, MD

Pediatric Hospitalist, Penn State Hershey Children's Hospital

Associate Professor of Pediatrics and Medicine, Penn State M. S. Hershey Medical Center

Hershey, PA

Upper Airway Infections

Heidi Wolf MD, FAAP

Director Pediatric Hospitalist Program, Johns Hopkins

Assistant Clinical Professor, John Hopkins University

Baltimore, MD

Fever of Unknown Origin

Neonatal Fever

Susan Wu, MD

Pediatric Hospitalist, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Bronchiolitis

Lisa B. Zaoutis, MD

Section Chief of Inpatient Services, Division of General Pediatrics, The Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Urinary Tract Infections

William T. Zempsky, MD

Associate Director; Division of Pain Medicine; Department of Pediatrics, Associate Director, Pain Relief Program, Connecticut Children's Medical Center

Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Pain Management

Reviewers

Allison Ballantine, MD

Medical Director of the Integrated Care Service, Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Technology Dependent Children

Margaret Hood, MD, FAAP

Pediatric Hospitalist, Seattle Children's Hospital

Clinical Associate Professor of Pediatrics, University of Washington

Seattle, WA

Hospice and Palliative Care

Ethics

Brian Kit, MD, MPH

Anne Arundel Medical Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Annapolis, MD

Advocacy

Evelina M. Krieger, MD

Children's National Medical Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Washington, DC

Advocacy

Cynthia L. Kuelbs, MD

Medical Director, Chadwick Center for Child Abuse; Division Director Pediatric Hospital Medicine, Rady Children's Hospital

Associate Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Child Abuse and Neglect

Christopher P. Landrigan, MD, MPH

Division Director, Pediatrics and Hospital Medicine; Research and Fellowship Director, Children's Hospital Boston Inpatient Pediatrics Service; Director, Sleep and Patient Safety Program at the Brigham and Women's Hospital, Children's Hospital Boston

Assistant Professor of Pediatrics and Medicine, Harvard Medical School

Boston, MA

Research

Michael Ruhlen, MD, MHCM, FAAP, FHM, FACHE

Vice President and Chief Medical Officer, Carolinas Medical Center Mercy

Carolinas Medical Center Pineville

Charlotte, NC

Legal Issues/Risk Management

Samir S. Shah, MD, MSCE

Senior Scholar, Center for Clinical Epidemiology and Biostatistics, The Children's Hospital of Philadelphia

Assistant Professor, Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine

Philadelphia, PA

Research

Rajendu Srivastava, MD, FRCP(C), MPH

Director of Pediatric Research in the Inpatient Setting (PRIS) Network, Primary Children's Medical Center, Intermountain Healthcare Inc.

Associate Professor, Division of Inpatient Medicine, Department of Pediatrics, University of Utah Health Sciences Center

Salt Lake City, UT

Research

Ben Bauer, MD, FAAP

Pediatric Hospital Medicine; Fellowship Director, Riley Children's Hospital, Indiana University School of Medicine

Indianapolis, IN

John Combes, MD

President/COO, Center for Healthcare Governance, American Hospital Association (AHA)

Washington, DC

Jennifer Daru, MD, FAAP, FHM

Chair‐elect AAP; Section on Hospital Medicine, American Academy of Pediatrics

San Francisco, CA

Jerrold Eichner, MD, FAAP

Chair, AAP National Committee on Hospital Care, American Academy of Pediatrics

Great Falls, MT

Rosemarie Faber, MSN/ED, RN, CCRN

Clinical Practice Specialist, American Association of Critical Care Nurses

Aliso Viejo, CA

Rani S Gereige, MD, MPH, FAAP

Director of Medical Education, Miami Children's Hospital

Miami, FL

David Jaimovich, MD, FAAP

President, QRI (Former Chief Medical Officer and Vice President for International Accreditation Services for Joint Commission Resources (JCR) and Joint Commission International (JCI)), Quality Resources International

Andrea Kline RN, MS, CPNP‐AC, CCRN, FCCM

Executive Board; Professional Issues; Pediatric Critical Care NP, National Association of Pediatric Nurse Practitioners (NAPNAP)

Cherry Hill, NJ

David D. Lloyd, MD, FRCP(C), FAAP

Section Chief of General Pediatrics Children's Healthcare of Atlanta, Director of Undergraduate Pediatric Education, Director of the Pediatric Hospitalist Fellowship, Children's Healthcare of Atlanta, Emory University School of Medicine

Atlanta, GA

Patricia S. Lye, MD, FAAP

AAP Section on Hospital Medicine, American Academy of Pediatrics

Milwaukee, WI

Sanjay Mahant, MD, FRCPC

Pediatric Hospital Medicine Fellowship Director, Hospital for Sick Children, University of Toronto School of Medicine

Toronto, Canada

Jennifer Maniscalco, MD, MPH, FAAP

Pediatric Hospital Medicine Fellowship Director, Children's Hospital Los Angeles

University of Southern California School of Medicine

Marlene Miller, MD, MSc, FAAP

Vice President for Quality, National Association of Children's Hospitals and Related Institutions (NACHRI)

Alexandria, VA

Paul E. Manicone, MD, FAAP

Associate Division Chief; Division of Hospitalist Medicine; Immediate past Fellowship Director, Children's National Medical Center, George Washington University School of Medicine

Washington DC

Warren Newton, MD

American Board of Family Medicine Board of Directors: Research and Development, IT, and Communications/publications Committees; Executive Associate Dean for Medical Education and William B. Aycock Distinguished Professor and Chair, Department of Family Medicine at the University of North Carolina at Chapel Hill, American Board of Family Medicine

Lexington, KY

Daniel Rauch, MD, FAAP, FHM

Chair, AAP Section on Hospital Medicine; Immediate Past Chair, Academic Pediatric Association Hospital Medicine Special Interest Group

AAP and APA

Ellen Schwalenstocker, PhD, MBA

Quality, Advocacy and Measurement, NACHRI

Alexandria, VA

Mary Jean Schuman, MSN, MBA, RN, CPNP

Chief Programs Officer, American Nursing Association

Silver Spring, MD

Neha H. Shah, MD, FAAP

Fellowship Director, Pediatric Hospital Medicine, Children's National Medical Center

George Washington University School of Medicine

Washington, DC

Geeta Singhal, MD, FAAP

Director, Pediatric Hospital Medicine Fellowship; Director, Faculty Inpatient Service; Co‐Director, PEM Faculty Development Program, Texas Children's Hospital, Baylor College of Medicine

Houston, TX

Jeffrey L. Sperring, MD, FAAP

Chair, Academic Pediatric Association Hospital Medicine Special Interest Group

Chief Medical Officer, Academic Pediatric Association

Indianapolis, IN

Erin R. Stucky, MD, FAAP, FHM

Pediatric Hospital Medicine, Fellowship Director, Rady Children's Hospital San Diego

University of California San Diego School of Medicine

San Diego, CA

Editors

Michael G. Burke, MD, MBA

Chairman of Pediatrics, Saint Agnes Hospital

Assistant Professor of Pediatrics, The Johns Hopkins University School of Medicine

Baltimore, MD

Douglas W. Carlson, MD

Chief, Pediatric Hospital Medicine, St. Louis Children's Hospital

Associate Professor of Pediatrics, Washington University

St. Louis, MO

Timothy T. Cornell, MD

C. S. Mott Women and Children's Hospital

Assistant Professor in the Department of Pediatrics and Communicable Diseases, University of Michigan

Ann Arbor, MI

Jack M. Percelay, MD, MPH, FAAP, FHM

Society of Hospital Medicine, Pediatric Board Member; Immediate Past‐Chair, AAP Section on Hospital Medicine, E.L.M.O. Pediatrics

Associate Professor, Pace University Physician Assistant Program

New York, New York

Daniel Rauch, MD, FAAP, FHM

Associate Director of Pediatrics, Elmhurst Hospital

New York

Anand Sekaran, MD

Medical Director, Inpatient Services, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

E. Douglas Thompson, Jr., MD

Director, Pediatric Generalist Service, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Heidi Wolf MD, FAAP

Director Pediatric Hospitalist Program, Johns Hopkins

Assistant Clinical Professor, John Hopkins University

Baltimore, MD

David Zipes, MD FAAP, FHM

Director, St. Vincent Pediatric Hospitalists, Peyton Manning Children's Hospital at St. Vincent

Indianapolis, IN

Senior Editors

Jennifer Maniscalco, MD, MPH, FAAP

Director of Education, Division of Pediatric Hospital Medicine, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Mary C. Ottolini MD, MPH, FAAP, FHM

Chair, Academic Pediatric Association Education Committee Immediate Past Hospitalist Division Chief; Vice Chair for Medical Education, Children's National Medical Center

Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Erin R. Stucky, MD, FAAP, FHM

Director of Graduate Medical Education, Rady Children's Hospital San Diego; Medical Director of Quality Improvement, Rady Children's Hospital San Diego; Associate Program Director, UCSD Pediatric Residency Program; Vice Chair for Clinical Affairs, UCSD Department of Pediatrics; Director, Pediatric Hospital Medicine Fellowship, Rady Children's Hospital

Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Rishi Agrawal, MD, MPH

Pediatric Hospitalist, Children's Memorial Hospital and LaRabida Children's Hospital

Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine

Chicago, IL

Feeding Tubes

Brian Alverson, MD

Head, Pediatric Hospitalist Section, Hasbro Children's Hospital

Assistant Professor of Pediatrics, Warren Alpert School of Medicine at Brown University

Providence, RI

Neonatal Fever

Pneumonia

Allison Ballantine, MD

Medical Director of the Integrated Care Service, Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Technology Dependent Children

Julia Beauchamp‐Walters, MD

Pediatric Emergency Transport Coordinator, CSSD, RCHHC Pediatric Emergency Transports, Rady Childrens Hospital

Clinical Instructor of Pediatrics, University of California, San Diego

San Diego, CA

Transport of the Critically Ill Child

Glenn F. Billman, MD

Medical Safety and Regulatory Officer, Rady Children's Hospital

San Diego, CA

Patient Safety

April O. Buchanan, MD, FAAP

Vice Chair of Quality, Department of Pediatrics, Children's Hospital at Greenville Hospital System University Medical Center

Assistant Professor of Clinical Pediatrics, University of South Carolina School of Medicine

Greenville, SC

Shock

Douglas W. Carlson, MD

Chief, Pediatric Hospital Medicine, St. Louis Children's Hospital

Associate Professor of Pediatrics, Washington University

St. Louis, MO

Procedural Sedation

Technology Dependent Children

Vincent W. Chiang, MD

Chief, Inpatient Services, Department of Medicine, Children's Hospital Boston

Associate Professor of Pediatrics, Harvard Medical School

Boston, MA

Seizures

Michael R. Clemmens, MD

Director Pediatric Hospitalist Program, Anne Arundel Medical Center

Assistant Clinical Professor of Pediatrics, The George Washington University School of Medicine

Annapolis, MD

Acute Abdominal Pain and The Acute Abdomen

Jamie L. Clute, MD, FAAP, FHM

Medical Director, Inpatient Services, Joe Dimaggio Children's Hospital

Clinical Assistant Professor, NOVA Southeastern University, College of Osteopathic Medicine and Assistant Affiliate Professor, Barry University

Hollywood, FL

Kawasaki Disease

Shannon Connor Phillips, MD, MPH

Patient Safety Officer, Quality and Patient Safety Institute, Cleveland Clinic

Assistant Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University

Cleveland, OH

Evidence Based Medicine

Tanya Dansky, MD

Medical Director, Children's Physicians Medical GroupMedical Director, San Diego Hospice and The Institute For Palliative Medicine, Rady Children's Hospital

Assistant Clinical Professor of Pediatrics, University of California, San Diego

San Diego, CA

Hospice and Palliative Care, Ethics

Jennifer Daru, MD, FAAP, FHM

Chief, Pediatric Hospitalist Division; Interim Chief, Pediatric and Neonatal Transport, California Pacific Medical Center

Clinical Assistant Professor (pending), University of California San Francisco

San Francisco, CA

Leading a Healthcare Team

Newborn Care and Delivery Room Management

Yasmeen N. Daud, MD

Director of Pediatric Hospitalist Sedation in the Pediatric Acute Wound Service and Director of the Pediatric Hospitalist After Hours Sedation Program, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Oxygen Delivery and Airway Management

Craig DeWolfe, MD, MEd

Pediatric Hospitalist, Children's National Medical Center

Assistant Professor of Pediatrics, George Washington School of Medicine and Health Sciences

Washington DC

Apparent Life‐Threatening Event

Joseph M. Geskey, DO

Division Chief, Pediatric Hospital Medicine, Medical Director of Hospital Care Management, Penn State Hershey Children's Hospital

Associate Professor of Pediatrics, Penn State M. S. Hershey Medical Center

Hershey, PA

Pneumonia

Upper Airway Infections

Bronchiolitis

Paul D. Hain, MD

Associate Chief of Staff, Monroe Carell Jr. Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics, Vanderbilt University

Nashville, TN

Health Information Systems

Keith Herzog, MD

Pediatric Hospitalist, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Central Nervous System Infections

Margaret Hood, MD, FAAP

Pediatric Hospitalist, Seattle Children's Hospital

Clinical Associate Professor of Pediatrics, University of Washington

Seattle, WA

Diabetes Mellitus

Hospice and Palliative Care

Kevin B. Johnson, MD, MS

Vice Chair of Biomedical Informatics, Vanderbilt University Medical Center

Associate Professor of Medical Informatics and Pediatrics, Vanderbilt University Medical Center

Nashville, TN

Health Information Systems

Rick Johnson, MD, FAAP

Division Head, Regional Pediatrics, CCMC, and American Heart Association Regional and National PALS Faculty, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Pediatric Advanced Life Support

Brian Kelly, MD, MRCP (UK), FAAP

Pediatric Hospitalist, Ranken Jordan Pediatric Rehabilitative Hospital, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Bladder Catheterization/Suprapubic Bladder Tap

Herbert C Kimmons, MD, MMM

President Children's Specialists of San Diego (Medical Quality Officer of Rady Children's Hospital of San Diego, 20062008), Children's Specialists of San Diego in California

Professor of Pediatrics, University of California San Diego

San Diego, CA

Continuous Quality Improvement

Patient Safety

Su‐Ting T. Li, MD, MPH

Associate Pediatric Residency Program Director, University of California, Davis

Assistant Professor of Pediatrics, University of California, Davis

Sacramento, CA

Skin and Soft Tissue Infections

Patricia S. Lye, MD

Medical Director, Hospitalists, Children's Hospital of Wisconsin

Associate Professor of Pediatrics, Medical College of Wisconsin

Milwaukee, WI

Transitions of Care

Jennifer Maniscalco, MD, MPH, FAAP

Director of Education, Division of Pediatric Hospital Medicine, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Failure to Thrive

Transitions of Care

Nutrition

David E. Marcello III, MD, FAAP

Pediatric Hospitalist, Connecticut Children's Medical Center

Assistant Professor in Pediatrics, University of Connecticut Medical School

Hartford, CT

Lumbar Puncture

Intravenous Access and Phlebotomy

Sanford M. Melzer, MD, MBA

Senior Vice President, Strategic Planning and Business Development, Seattle Children's Hospital

Professor of Pediatrics, University of Washington School of Medicine

Seattle, WA

Cost Effective Care

Margaret I. Mikula, MD

Pediatric Hospitalist, Penn State Hershey Children's Hospital

Assistant Professor of Pediatrics, Penn State M. S. Hershey Medical Center

Hershey, PA

Pneumonia

Bronchiolitis

Laura J Mirkinson, MD, FAAP

Director of Pediatrics, Blythedale Children's Hospital

Valhalla, NY

Neonatal Jaundice

Christopher D. Miller, MD, FAAP

Pediatric Hospitalist and Allergist, Children's Mercy Hospitals and Clinics

Assistant Professor of Pediatrics, University of Missouri‐Kansas City School of Medicine

Kansas City, MO

Asthma

Christopher O'Hara, MD, FACP

St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia PA

Pain Management

Mary C. Ottolini MD, MPH, FAAP, FHM

Chair, Academic Pediatric Association Education Committee Immediate Past Hospitalist Division Chief; Vice Chair for Medical Education, Children's National Medical Center

Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Fluid and Electrolyte Management

Gastroenteritis

Education

Brian M. Pate, MD, FAAP, FHM

Section Chief, Pediatric Hospital Medicine, Vice Chairman, Inpatient Services, Children's Mercy Hospital and Clinics

Assistant Professor of Pediatrics, University of Missouri‐Kansas City School of Medicine

Business Practices

Asthma

Dana Patrick, RN, BSN

Transport Program Manager NICU\PICU, Rady Children's Hospital

San Diego, CA

Transport of the Critically Ill Child

Jack M. Percelay, MD, MPH, FAAP, FHM

Society of Hospital Medicine, Pediatric Board Member; Immediate Past‐Chair, AAP Section on Hospital Medicine, E.L.M.O. Pediatrics

Associate Professor, Pace University Physician Assistant Program

New York, New York

Advocacy

David Pressel, MD, PhD, FHM, FAAP

Director, General Pediatrics Inpatient Services, A.I. duPont Hospital for Children

Assistant Professor of Pediatrics, Jefferson Medical College, Thomas Jefferson University

Wilmington, DE

Child Abuse and Neglect

Kris P Rehm, MD

Director, Division of Hospital Medicine, Monroe Carell Jr Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics, Vanderbilt University

Nashville, TN

Respiratory Failure

Kyung E. Rhee, MD, MSc

Pediatric Hospitalist, Hasbro Children's Hospital and The Weight Control and Diabetes Research Center

Assistant Professor of Pediatrics, Warren Alpert Medical School of Brown University

Providence, RI

Fever of Unknown Origin

Mark F Riederer, MD

Pediatric Hospitalist, Monroe Carell Jr Children's Hospital at Vanderbilt

Assistant Professor of Pediatrics,

Nashville, TN

Respiratory Failure

Michael Ruhlen, MD, MHCM, FAAP, FHM, FACHE

Vice President and Chief Medical Officer, Carolinas Medical Center Mercy

Carolinas Medical Center Pineville

Charlotte, NC

Legal Issues/Risk Management

Henry M. Seidel, MD

Professor Emeritus, Johns Hopkins Berman Institute of Bioethics

Professor Emeritus of Pediatrics, The Johns Hopkins University School of Medicine

Baltimore, MD

Communication

Anand Sekaran, MD

Medical Director, Inpatient Services, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Radiographic Interpretation

Kristin A. Shadman, MD, FAAP

Pediatric Hospitalist

Oxygen Delivery and Airway Management

Vipul Singla, MD, FAAP

Site Leader, Lake Forest Hospital (Children's Memorial Medical Group)

Instructor in Pediatrics, Northwestern University Feinberg School of Medicine

Chicago, IL

Electrocardiogram Interpretation

Karen Smith, MD, MEd

Chief Medical Officer, The HSC Pediatric Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Apparent Life‐Threatening Event

Jeffrey L. Sperring, MD

Chief Medical Officer, Riley Hospital for Children

Assistant Professor of Pediatrics, Indiana University School of Medicine

Indianapolis, IN

Bone and Joint Infections

Glenn Stryjewski, MD, MPH

Associate Residency Program Director, AI duPont Hospital for Children

Assistant professor of Pediatrics, Jefferson Medical College, Thomas Jefferson University

Wilmington, DE

Toxic Ingestion

Erin R. Stucky, MD, FAAP, FHM

Director of Graduate Medical Education, Rady Children's Hospital San Diego; Medical Director of Quality Improvement, Rady Children's Hospital San Diego; Associate Program Director, UCSD Pediatric Residency Program; Vice Chair for Clinical Affairs, UCSD Department of Pediatrics; Director, Pediatric Hospital Medicine Fellowship, Rady Children's Hospital

Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Evidence Based Medicine

Continuous Quality Improvement

Technology Dependent Children

E. Douglas Thompson, Jr., MD

Director, Pediatric Generalist Service, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Sickle Cell Disease

Michael Turmelle, MD

Pediatric Hospitalist, St. Louis Children's Hospital

Assistant Professor of Pediatrics, Washington University School of Medicine

St. Louis, MO

Non‐Invasive Monitoring

Macdara G. Tynan, MD, MBA, FAAP

Associate Director of Inpatient Pediatrics, Levine Children's Hospital

Charlotte, NC

Diabetes Mellitus

Toxic Ingestion

Ronald J. Williams, MD

Pediatric Hospitalist, Penn State Hershey Children's Hospital

Associate Professor of Pediatrics and Medicine, Penn State M. S. Hershey Medical Center

Hershey, PA

Upper Airway Infections

Heidi Wolf MD, FAAP

Director Pediatric Hospitalist Program, Johns Hopkins

Assistant Clinical Professor, John Hopkins University

Baltimore, MD

Fever of Unknown Origin

Neonatal Fever

Susan Wu, MD

Pediatric Hospitalist, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Bronchiolitis

Lisa B. Zaoutis, MD

Section Chief of Inpatient Services, Division of General Pediatrics, The Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Urinary Tract Infections

William T. Zempsky, MD

Associate Director; Division of Pain Medicine; Department of Pediatrics, Associate Director, Pain Relief Program, Connecticut Children's Medical Center

Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

Pain Management

Reviewers

Allison Ballantine, MD

Medical Director of the Integrated Care Service, Children's Hospital of Philadelphia

Assistant Professor of Pediatrics, University of Pennsylvania School of Medicine

Philadelphia, PA

Technology Dependent Children

Margaret Hood, MD, FAAP

Pediatric Hospitalist, Seattle Children's Hospital

Clinical Associate Professor of Pediatrics, University of Washington

Seattle, WA

Hospice and Palliative Care

Ethics

Brian Kit, MD, MPH

Anne Arundel Medical Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Annapolis, MD

Advocacy

Evelina M. Krieger, MD

Children's National Medical Center

Assistant Professor of Pediatrics, The George Washington University School of Medicine

Washington, DC

Advocacy

Cynthia L. Kuelbs, MD

Medical Director, Chadwick Center for Child Abuse; Division Director Pediatric Hospital Medicine, Rady Children's Hospital

Associate Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Child Abuse and Neglect

Christopher P. Landrigan, MD, MPH

Division Director, Pediatrics and Hospital Medicine; Research and Fellowship Director, Children's Hospital Boston Inpatient Pediatrics Service; Director, Sleep and Patient Safety Program at the Brigham and Women's Hospital, Children's Hospital Boston

Assistant Professor of Pediatrics and Medicine, Harvard Medical School

Boston, MA

Research

Michael Ruhlen, MD, MHCM, FAAP, FHM, FACHE

Vice President and Chief Medical Officer, Carolinas Medical Center Mercy

Carolinas Medical Center Pineville

Charlotte, NC

Legal Issues/Risk Management

Samir S. Shah, MD, MSCE

Senior Scholar, Center for Clinical Epidemiology and Biostatistics, The Children's Hospital of Philadelphia

Assistant Professor, Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine

Philadelphia, PA

Research

Rajendu Srivastava, MD, FRCP(C), MPH

Director of Pediatric Research in the Inpatient Setting (PRIS) Network, Primary Children's Medical Center, Intermountain Healthcare Inc.

Associate Professor, Division of Inpatient Medicine, Department of Pediatrics, University of Utah Health Sciences Center

Salt Lake City, UT

Research

Ben Bauer, MD, FAAP

Pediatric Hospital Medicine; Fellowship Director, Riley Children's Hospital, Indiana University School of Medicine

Indianapolis, IN

John Combes, MD

President/COO, Center for Healthcare Governance, American Hospital Association (AHA)

Washington, DC

Jennifer Daru, MD, FAAP, FHM

Chair‐elect AAP; Section on Hospital Medicine, American Academy of Pediatrics

San Francisco, CA

Jerrold Eichner, MD, FAAP

Chair, AAP National Committee on Hospital Care, American Academy of Pediatrics

Great Falls, MT

Rosemarie Faber, MSN/ED, RN, CCRN

Clinical Practice Specialist, American Association of Critical Care Nurses

Aliso Viejo, CA

Rani S Gereige, MD, MPH, FAAP

Director of Medical Education, Miami Children's Hospital

Miami, FL

David Jaimovich, MD, FAAP

President, QRI (Former Chief Medical Officer and Vice President for International Accreditation Services for Joint Commission Resources (JCR) and Joint Commission International (JCI)), Quality Resources International

Andrea Kline RN, MS, CPNP‐AC, CCRN, FCCM

Executive Board; Professional Issues; Pediatric Critical Care NP, National Association of Pediatric Nurse Practitioners (NAPNAP)

Cherry Hill, NJ

David D. Lloyd, MD, FRCP(C), FAAP

Section Chief of General Pediatrics Children's Healthcare of Atlanta, Director of Undergraduate Pediatric Education, Director of the Pediatric Hospitalist Fellowship, Children's Healthcare of Atlanta, Emory University School of Medicine

Atlanta, GA

Patricia S. Lye, MD, FAAP

AAP Section on Hospital Medicine, American Academy of Pediatrics

Milwaukee, WI

Sanjay Mahant, MD, FRCPC

Pediatric Hospital Medicine Fellowship Director, Hospital for Sick Children, University of Toronto School of Medicine

Toronto, Canada

Jennifer Maniscalco, MD, MPH, FAAP

Pediatric Hospital Medicine Fellowship Director, Children's Hospital Los Angeles

University of Southern California School of Medicine

Marlene Miller, MD, MSc, FAAP

Vice President for Quality, National Association of Children's Hospitals and Related Institutions (NACHRI)

Alexandria, VA

Paul E. Manicone, MD, FAAP

Associate Division Chief; Division of Hospitalist Medicine; Immediate past Fellowship Director, Children's National Medical Center, George Washington University School of Medicine

Washington DC

Warren Newton, MD

American Board of Family Medicine Board of Directors: Research and Development, IT, and Communications/publications Committees; Executive Associate Dean for Medical Education and William B. Aycock Distinguished Professor and Chair, Department of Family Medicine at the University of North Carolina at Chapel Hill, American Board of Family Medicine

Lexington, KY

Daniel Rauch, MD, FAAP, FHM

Chair, AAP Section on Hospital Medicine; Immediate Past Chair, Academic Pediatric Association Hospital Medicine Special Interest Group

AAP and APA

Ellen Schwalenstocker, PhD, MBA

Quality, Advocacy and Measurement, NACHRI

Alexandria, VA

Mary Jean Schuman, MSN, MBA, RN, CPNP

Chief Programs Officer, American Nursing Association

Silver Spring, MD

Neha H. Shah, MD, FAAP

Fellowship Director, Pediatric Hospital Medicine, Children's National Medical Center

George Washington University School of Medicine

Washington, DC

Geeta Singhal, MD, FAAP

Director, Pediatric Hospital Medicine Fellowship; Director, Faculty Inpatient Service; Co‐Director, PEM Faculty Development Program, Texas Children's Hospital, Baylor College of Medicine

Houston, TX

Jeffrey L. Sperring, MD, FAAP

Chair, Academic Pediatric Association Hospital Medicine Special Interest Group

Chief Medical Officer, Academic Pediatric Association

Indianapolis, IN

Erin R. Stucky, MD, FAAP, FHM

Pediatric Hospital Medicine, Fellowship Director, Rady Children's Hospital San Diego

University of California San Diego School of Medicine

San Diego, CA

Editors

Michael G. Burke, MD, MBA

Chairman of Pediatrics, Saint Agnes Hospital

Assistant Professor of Pediatrics, The Johns Hopkins University School of Medicine

Baltimore, MD

Douglas W. Carlson, MD

Chief, Pediatric Hospital Medicine, St. Louis Children's Hospital

Associate Professor of Pediatrics, Washington University

St. Louis, MO

Timothy T. Cornell, MD

C. S. Mott Women and Children's Hospital

Assistant Professor in the Department of Pediatrics and Communicable Diseases, University of Michigan

Ann Arbor, MI

Jack M. Percelay, MD, MPH, FAAP, FHM

Society of Hospital Medicine, Pediatric Board Member; Immediate Past‐Chair, AAP Section on Hospital Medicine, E.L.M.O. Pediatrics

Associate Professor, Pace University Physician Assistant Program

New York, New York

Daniel Rauch, MD, FAAP, FHM

Associate Director of Pediatrics, Elmhurst Hospital

New York

Anand Sekaran, MD

Medical Director, Inpatient Services, Connecticut Children's Medical Center

Assistant Professor of Pediatrics, University of Connecticut School of Medicine

Hartford, CT

E. Douglas Thompson, Jr., MD

Director, Pediatric Generalist Service, St. Christopher's Hospital for Children

Assistant Professor of Pediatrics, Drexel University College of Medicine

Philadelphia, PA

Heidi Wolf MD, FAAP

Director Pediatric Hospitalist Program, Johns Hopkins

Assistant Clinical Professor, John Hopkins University

Baltimore, MD

David Zipes, MD FAAP, FHM

Director, St. Vincent Pediatric Hospitalists, Peyton Manning Children's Hospital at St. Vincent

Indianapolis, IN

Senior Editors

Jennifer Maniscalco, MD, MPH, FAAP

Director of Education, Division of Pediatric Hospital Medicine, Children's Hospital Los Angeles

Clinical Assistant Professor of Pediatrics, University of Southern California Keck School of Medicine

Los Angeles, CA

Mary C. Ottolini MD, MPH, FAAP, FHM

Chair, Academic Pediatric Association Education Committee Immediate Past Hospitalist Division Chief; Vice Chair for Medical Education, Children's National Medical Center

Professor of Pediatrics, The George Washington University School of Medicine

Washington DC

Erin R. Stucky, MD, FAAP, FHM

Director of Graduate Medical Education, Rady Children's Hospital San Diego; Medical Director of Quality Improvement, Rady Children's Hospital San Diego; Associate Program Director, UCSD Pediatric Residency Program; Vice Chair for Clinical Affairs, UCSD Department of Pediatrics; Director, Pediatric Hospital Medicine Fellowship, Rady Children's Hospital

Clinical Professor of Pediatrics, University of California San Diego

San Diego, CA

Issue
Journal of Hospital Medicine - 5(2)
Issue
Journal of Hospital Medicine - 5(2)
Page Number
vii-xv
Page Number
vii-xv
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