The Academic Pediatric Association fully endorses the Pediatric Hospitalist Medicine Core Competencies to define the knowledge skills and attitudes necessary to provide the highest quality of inpatient care for our nation's children. We will continue to lead and collaborate in projects to develop, implement and evaluate educational projects to disseminate the Competencies.
A B S T R A C TOBJECTIVES: Hospitals are employing more nurse practitioners and physician assistants on inpatient pediatric units. With this study, we compared patient outcomes in high-volume inpatient diagnoses on pediatric hospital medicine services staffed by attending physician hospitalists and residents (hospitalist and resident service [HRS]) with 1 staffed by attending physician hospitalists and advanced practice providers (HAPPS).
METHODS:A historical cohort study was implemented by using administrative data for patients admitted to HRS and HAPPS from 2007 to 2011 with asthma, bronchiolitis, cellulitis, and pneumonia with severity levels 1 and 2 for all-patient refined diagnosis-related groups. Length of stay, readmission, ICU transfer, and hospital charges were compared.
RESULTS:After controlling for clinical, demographic, and socioeconomic differences, the average probability of discharge was 10% greater each day (event ratio [ER] 5 1.1 [1.06-1.14]) on HAPPS compared with HRS. By diagnosis, this trend persisted with asthma (ER 5 1.07 [1.02-1.12]), cellulitis (ER 5 1.2 [1.1-1.3]), and pneumonia (ER 5 1.17 [1.08-1.28]) but not for bronchiolitis (ER 5 0.99 [0.92-1.06]). Both 3-and 30-day readmissions were higher for HRS discharges with bronchiolitis (odds ratio 5 5.9 [1.3-28.6] and 2.0 [1.3-3.3], respectively) but not for the other diagnoses. Hospital charges were 13% higher for patients on HRS than HAPPS. ICU transfers did not differ statistically.
CONCLUSIONS:Within the limitations of the design, HAPPS performed at least as well as HRS with respect to length of stay, readmissions, ICU transfers, and charges for 4 of the most common inpatient diagnoses with severity levels 1 to 2. Indicated in these results is that in this configuration, advanced practice providers on pediatric hospitalist services represent a viable model for other institutions to consider and test.
Introduction: An increasing number of medical students complete clerkships outside of traditional university-affiliated medical centers despite little faculty development geared specifically for the community preceptor. Moreover, the community setting presents a unique set of challenges, including fewer educational resources, greater expectation of clinical productivity, and a wide geographic distribution of preceptors. Methods: This 90-minute workshop provided pediatric community preceptors with effective teaching strategies that could be used in their setting. First, participants identified opportunities and challenges for medical student education in the community setting. Then, participants discussed approaches to strengthen the students' learning experience in small-group breakout sessions. Finally, workshop leaders emphasized specific teaching resources and methods to empower participants. Results: This workshop was presented at three national pediatric conferences and had at least 57 participants (40 total respondents). Over the three iterations, participants consistently rated this workshop as highly effective and engaging, with the small-group breakout session rated most engaging. Over time, modifications to the workshop included lengthening breakout sessions, shortening didactic materials to enhance audience discussion, and expanding content to include the outpatient setting. In later iterations, participants identified a specific medical education challenge at their institution and committed to using a technique they learned from the workshop. Discussion: This workshop targeted inpatient and outpatient pediatric preceptors to address the community-based faculty development gap. After completing the workshop, community preceptors can enhance the medical education experience by optimizing invaluable opportunities in the community setting and applying targeted strategies and resources.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.