2024
Procalcitonin Use After Clinical Practice Guideline and QI Intervention for Febrile Infants.
Shine A, Bryan M, Brown M, Aronson P, McDaniel C. Procalcitonin Use After Clinical Practice Guideline and QI Intervention for Febrile Infants. Hospital Pediatrics 2024 PMID: 39295527, DOI: 10.1542/hpeds.2024-007906.Peer-Reviewed Original ResearchParental Preferences and Shared Decision-Making for the Management of Febrile Young Infants.
Sylvestre P, Aronson P, Yannopoulos A, Poirier C, Gaucher N, Burstein B. Parental Preferences and Shared Decision-Making for the Management of Febrile Young Infants. Pediatrics 2024, 154.0 PMID: 39285842, PMCID: PMC11422194, DOI: 10.1542/peds.2024-066420.Peer-Reviewed Original ResearchDecisional involvementFocus groupsMedical recommendationsFebrile young infantsSequential explanatory mixed-methods studyExplanatory mixed-methods studyAspects of careStressful aspectsInfant medical careQualitative focus groupsCross-sectional questionnaireMixed-methods studyParental preferencesLumbar punctureDecision-making experiencesTertiary pediatric hospitalTailored informationYoung infantsMedical careMedical teamSupportive relationshipsInfant careManagement of febrile young infantsPediatric hospitalFamily expectationsDisparities in Guideline Adherence for Febrile Infants in a National Quality Improvement Project.
McDaniel C, Truschel L, Kerns E, Polanco Y, Liang D, Gutman C, Cunningham S, Rooholamini S, Thull-Freedman J, Jennings B, Magee S, Aronson P. Disparities in Guideline Adherence for Febrile Infants in a National Quality Improvement Project. Pediatrics 2024, 154 PMID: 39155728, PMCID: PMC11350103, DOI: 10.1542/peds.2024-065922.Peer-Reviewed Original ResearchConceptsQuality improvementDelivery of evidence-based careStandard careEmergency departmentNational quality improvement projectNon-Hispanic black infantsEvidence-based careQuality improvement projectDocumentation of follow-upAssociation of raceNon-Hispanic white infantsClinical practice guidelinesCross-sectional studyPediatrics clinical practice guidelineQI collaborativeEquitable deliveryGuideline implementationFollow-upEthnic disparitiesGuideline adherenceGuideline-concordantIntervention periodAmerican Academy of Pediatrics clinical practice guidelineImprovement projectPractice guidelinesDisposition and Follow-up for Low-Risk Febrile Infants: A Secondary Analysis of a Multicenter Study.
Kannikeswaran N, Spencer P, Tedford N, Truschel L, Chu J, Dingeldein L, Waseem M, Chow J, Lababidi A, Theiler C, Bhalodkar S, Yan X, Lou X, Fernandez R, Aronson P, Lion K, Gutman C. Disposition and Follow-up for Low-Risk Febrile Infants: A Secondary Analysis of a Multicenter Study. Hospital Pediatrics 2024, 14: e379-e384. PMID: 39113626, PMCID: PMC11358591, DOI: 10.1542/hpeds.2024-007850.Peer-Reviewed Original ResearchConceptsFebrile infantsFollow-upPrimary care providersElectronic health record documentationElectronic health recordsDischarged infantsEmergency departmentED dispositionLow riskAmerican Academy of Pediatrics guidelinesInvasive bacterial infectionsSecondary analysisCross-sectional studyMulticenter studyPost-discharge follow-upPediatric guidelinesWeekday visitsBacterial infectionsInfantsQuality of careAmerican AcademyMulticenterCare planningCare providersPatient-centeredManagement of race, ethnicity, and language data in the pediatric emergency department
Gutman C, Hartford E, Gifford S, Ford V, Bouvay K, Pickett M, Tran T, Slade N, Piroutek M, Chung S, Roach B, Hincapie M, Hoffmann J, Lin K, Kotler H, Pulcini C, Rose J, Bergmann K, Cheng T, St. Pierre Hetz R, Yan X, Lou X, Fernandez R, Aronson P, Lion K, Group T. Management of race, ethnicity, and language data in the pediatric emergency department. Academic Emergency Medicine 2024 PMID: 38808384, DOI: 10.1111/acem.14947.Peer-Reviewed Original ResearchImproving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative.
McDaniel C, Kerns E, Jennings B, Magee S, Biondi E, Flores R, Aronson P. Improving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative. Pediatrics 2024, 153 PMID: 38682245, DOI: 10.1542/peds.2023-063339.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesFebrile infantsAmerican Academy of Pediatrics clinical practice guidelineSecondary measuresAAP clinical practice guidelinesPediatrics clinical practice guidelineInvasive bacterial infectionsQI collaborativeIntervention bundleAdherence to specific recommendationsDischarge of infantsGuideline-concordant careInfants aged 8Clinical practice guideline recommendationsPrimary measureQuality improvementOral antibioticsEmergency department dischargePositive urinalysisAssociated with improvementsQualifying infantsQuality improvement initiativesAdministered antibioticsGuideline recommendationsCerebrospinal fluidChanging patterns of routine laboratory testing over time at children's hospitals
Tchou M, Hall M, Markham J, Stephens J, Steiner M, McCoy E, Aronson P, Shah S, Molloy M, Cotter J. Changing patterns of routine laboratory testing over time at children's hospitals. Journal Of Hospital Medicine 2024, 19: 671-679. PMID: 38643414, PMCID: PMC11296890, DOI: 10.1002/jhm.13372.Peer-Reviewed Original ResearchTesting ratesChildren's hospitalED revisitsLength of stayRetrospective cohort study of children aged 0Study of children aged 0Annual testing ratesLaboratory testing ratesPediatric Health Information System databaseHealth Information System databaseChildren aged 0Case mix indexInformation System databaseResource utilization trendsRetrospective cohort studyAged 0Group hospitalsPatient daysReadmission ratesPatient outcomesSeparate hospitalsHospitalSystem databaseUtilization trendsMulti-centerPredictors of Invasive Bacterial Infection in Febrile Infants Aged 2 to 6 Months in the Emergency Department
Green R, Sartori L, Florin T, Aronson P, Lee B, Chamberlain J, Hunt K, Michelson K, Nigrovic L. Predictors of Invasive Bacterial Infection in Febrile Infants Aged 2 to 6 Months in the Emergency Department. The Journal Of Pediatrics 2024, 270: 114017. PMID: 38508484, DOI: 10.1016/j.jpeds.2024.114017.Peer-Reviewed Original Research“Let Us Take Care of the Medicine”: A Qualitative Analysis of Physician Communication When Caring for Febrile Infants
Gutman C, Fernandez R, McFarlane A, Krajewski J, Lion K, Aronson P, Bylund C, Holmes S, Fisher C. “Let Us Take Care of the Medicine”: A Qualitative Analysis of Physician Communication When Caring for Febrile Infants. Academic Pediatrics 2024, 24: 949-956. PMID: 38458491, DOI: 10.1016/j.acap.2024.03.002.Peer-Reviewed Original ResearchPatient-centered communicationPatient-centerednessPhysicians' assumptionsEmergency departmentThematic analysis of interview transcriptsParent-physician interactionsAnalysis of interview transcriptsAcademic pediatric emergency departmentIdentification of themesPediatric emergency departmentHealth inequalitiesPhysician communicationThematic saturationPhysicians' perceptionsED physiciansHealth careSemistructured interviewsInfant guidelinesThematic analysisInterview transcriptsPhysiciansCareHealthMethods approachManagement of febrile infantsPhlebotomy‐free days in children hospitalized with common infections and their association with clinical outcomes
Collins M, Hall M, Shah S, Molloy M, Aronson P, Cotter J, Steiner M, McCoy E, Tchou M, Stephens J, Markham J. Phlebotomy‐free days in children hospitalized with common infections and their association with clinical outcomes. Journal Of Hospital Medicine 2024, 19: 251-258. PMID: 38348499, PMCID: PMC11155307, DOI: 10.1002/jhm.13282.Peer-Reviewed Original ResearchCare of hospitalized childrenHospital quality measuresCross-sectional study of childrenPatient Refined Diagnosis Related GroupsPediatric Health Information System databaseHealth Information System databaseCross-sectional studyClinical outcomesDiagnosis Related GroupsInformation System databaseInterhospital transferIn-hospital mortalityMedical complexityStudy of childrenLaboratory blood testsTotal hospital LOSAssociated with outcomeAdjustment outcomesBlood testsOsteoarticular infectionsHospitalSystem databaseHospital LOSQuality measuresRelated groupsInfants With Hypothermia: Are They Just Like Febrile Infants?
Yankova L, Aronson P. Infants With Hypothermia: Are They Just Like Febrile Infants? Hospital Pediatrics 2024, 14: e161-e163. PMID: 38312018, DOI: 10.1542/hpeds.2023-007641.Commentaries, Editorials and LettersFebrile infants aged ≤60 days: evaluation and management in the emergency department.
Palladino L, Woll C, Aronson P. Febrile infants aged ≤60 days: evaluation and management in the emergency department. Pediatric Emergency Medicine Practice 2024, 21: 1-28. PMID: 38266065.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsBacterial infectionsManagement of febrile young infantsAmerican Academy of Pediatrics clinical practice guidelineYoung infantsFebrile young infantsPediatrics clinical practice guidelineEmergency departmentUrinary tract infectionRisk stratification toolPositive viral testClinical practice guidelinesTract infectionsViral testingEmergency cliniciansSevere outcomesAmerican AcademyInfectionPractice guidelinesInfantsDepartmentFeverEmergencyContaminant Organism Growth in Febrile Infants at Low Risk for Invasive Bacterial Infection
Singh N, Gutman C, Green R, Thompson A, Jackson K, Kalari N, Lucrezia S, Krack A, Corboy J, Cheng T, Duong M, St Pierre-Hetz R, Akinsola B, Kelly J, Sartori L, Yan X, Lou X, Lion K, Fernandez R, Aronson P, Group P. Contaminant Organism Growth in Febrile Infants at Low Risk for Invasive Bacterial Infection. The Journal Of Pediatrics 2024, 267: 113910. PMID: 38218368, DOI: 10.1016/j.jpeds.2024.113910.Peer-Reviewed Original Research
2023
Clinician Management Practices for Infants With Hypothermia in the Emergency Department.
Ramgopal S, Graves C, Aronson P, Cruz A, Rogers A. Clinician Management Practices for Infants With Hypothermia in the Emergency Department. Pediatrics 2023, 152 PMID: 38009075, DOI: 10.1542/peds.2023-063000.Peer-Reviewed Original ResearchConceptsSerious bacterial infectionsManagement of infantsEmergency departmentTreatment preferencesRespiratory viral testingSimplex virus infectionUS pediatric hospitalsProportion of cliniciansDays of ageClinician testingFebrile infantsED cliniciansInfants 0Pediatric hospitalViral testingClinician comfortVirus infectionAntimicrobial administrationHypothermiaYoung infantsOlder infantsInfantsBacterial infectionsCliniciansAgePerspectives of Adolescents and Young Adults with Sickle Cell Disease and Clinicians on Improving Transition Readiness and a Videogame Intervention
Aronson P, Nolan S, Schaeffer P, Hieftje K, Ponce K, Calhoun C. Perspectives of Adolescents and Young Adults with Sickle Cell Disease and Clinicians on Improving Transition Readiness and a Videogame Intervention. Blood 2023, 142: 5116. DOI: 10.1182/blood-2023-173310.Peer-Reviewed Original ResearchAdult careSickle cell diseaseTransition readinessPatient engagementClinician experienceVideogame interventionCell diseaseMedical decisionsYoung adultsDisease-specific knowledgeQuaternary care hospitalYoung SCD patientsSuccessful home managementHigh rateParents/caregiversPain crisisCare hospitalPatient factorsSuccessful disease managementHealthcare utilizationSCD patientsClinical manifestationsEmergency departmentProvider judgmentClinician's perspectiveEffect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay.
Winer J, Richardson T, Berg K, Berry J, Chang P, Etinger V, Hall M, Kim G, Meneses Paz J, Treasure J, Aronson P. Effect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay. Hospital Pediatrics 2023, 13: 1018-1027. PMID: 37795554, PMCID: PMC10593863, DOI: 10.1542/hpeds.2023-007295.Peer-Reviewed Original ResearchConceptsEffect of HFNCICU servicesEffect modifiersHigh-flow nasal cannula therapyMulticenter retrospective cohort studyPediatric Health Information SystemAge groupsHigh-flow nasal cannulaNon-ICU patientsRetrospective cohort studyComplex chronic conditionsMultivariable Poisson regressionFuture prospective studiesPotential effect modifiersInitial desaturationInitial tachypneaCohort studyClinical factorsNasal cannulaHospital recordsProspective studyHospitalized childrenChronic conditionsHFNCPatientsRacial and Ethnic Differences in Insurer Classification of Nonemergent Pediatric Emergency Department Visits
Pomerantz A, De Souza H, Hall M, Neuman M, Goyal M, Samuels-Kalow M, Aronson P, Alpern E, Simon H, Hoffmann J, Wells J, Shanahan K, Gutman C, Peltz A. Racial and Ethnic Differences in Insurer Classification of Nonemergent Pediatric Emergency Department Visits. JAMA Network Open 2023, 6: e2311752. PMID: 37140920, PMCID: PMC10160869, DOI: 10.1001/jamanetworkopen.2023.11752.Peer-Reviewed Original ResearchConceptsUnique ED visitsED visitsPediatric ED visitsClaims algorithmHispanic childrenMore visitsReimbursement reductionsHispanic pediatric patientsNonemergent ED visitsCurrent Procedural Terminology codesEmergency department visitsPediatric emergency departmentPrimary care servicesProcedural Terminology codesWhite childrenProfessional reimbursementCommercial health insurerRetrospective cohortDate of birthDepartment visitsPediatric patientsStudy cohortEmergency departmentMedicaid databaseDiagnosis codesPrevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2
Aronson P, Louie J, Kerns E, Jennings B, Magee S, Wang M, Gupta N, Kovaleski C, McDaniel L, McDaniel C, Agbim C, Amadasun O, Beam N, Beamon B, Becker H, Bedard E, Biondi E, Boulet J, Bray-Aschenbrenner A, Brooks R, Chen C, Corboy J, Dawlabani N, De Angulo G, Demie S, Drexler J, Dudley N, Ellis A, Fath K, Frauenfelder A, Gill J, Graf T, Grageda M, Greening H, Griffin A, Groen A, Guernsey III D, Gustafson S, Hancock W, Iyer S, Jaiyeola P, Jayanth A, Jennings R, Kachan-Liu S, Kamat A, Kennedy I, Khateeb L, Khilji O, Kleweno E, Kumar A, Kwon S, La A, Laeven-Sessions P, Le K, Leazer R, Levasseur K, Lewis E, Maalouli W, Mackenzie B, Mahoney K, Margulis D, Maskin L, McCarty E, Monroy A, Morrison J, Myszewski J, Nadeau N, Nagappan S, Newcomer K, Nordstrom M, Nguyen D, O'Day P, Oumarbaeva-Malone Y, Parlin U, Peters S, Piroutek M, Quarrie R, Rice K, Romano T, Rooholamini S, Schroeder C, Segar E, Seitzinger P, Sharma S, Simpson B, Singh P, Sobeih Y, Sojar S, Srinivasan K, Sterrett E, Swift-Taylor M, Szkola S, Thull-Freedman J, Topoz I, Vayngortin T, Veit C, Ventura-Polanco Y, Wallace Wu A, Weiss L, Wong E, Zafar S. Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2. JAMA Network Open 2023, 6: e2313354. PMID: 37171815, PMCID: PMC10182434, DOI: 10.1001/jamanetworkopen.2023.13354.Peer-Reviewed Original ResearchConceptsPrevalence of UTIUrinary tract infectionSARS-CoV-2SARS-CoV-2-positive infantsSARS-CoV-2 testingFebrile infantsBacterial meningitisTract infectionsSARS-CoV-2 positivityMulticenter cross-sectional studyInflammatory marker levelsMedical record reviewProportion of infantsCross-sectional studyQuality improvement initiativesRecord reviewEmergency departmentMarker levelsLower proportionBacteremiaMAIN OUTCOMEMeningitisInfantsAge groupsBacterial infections149 A Mixed Methods Analysis of Disparities in the Management of Low-Risk Febrile Infants
Gutman C, Aronson P, Lion K, Fisher C, McFarlane A, Bylund C, Fernandez R. 149 A Mixed Methods Analysis of Disparities in the Management of Low-Risk Febrile Infants. Journal Of Clinical And Translational Science 2023, 7: 45-45. PMCID: PMC10129715, DOI: 10.1017/cts.2023.230.Peer-Reviewed Original ResearchLow-risk febrile infantsStandard of careFebrile infantsPhysician-parent communicationMulticenter cross-sectional studyInvasive bacterial infectionsPediatric emergency departmentCross-sectional studyEmergency departmentLumbar puncturePhysician interviewsModifiable targetsModifiable driversProfessional interpretationInfant raceInfantsBacterial infectionsPhysician behaviorHealth disparitiesLogistic regressionHealth equityFuture interventionsCareInfluence management decisionsResults/Variation in stool testing for children with acute gastrointestinal infections
Markham J, Hall M, Collins M, Shah S, Molloy M, Aronson P, Cotter J, Steiner M, McCoy E, Tchou M, Stephens J. Variation in stool testing for children with acute gastrointestinal infections. Journal Of Hospital Medicine 2023, 18: 473-482. PMID: 36988413, PMCID: PMC11340271, DOI: 10.1002/jhm.13087.Peer-Reviewed Original ResearchConceptsAcute gastrointestinal infectionsStool testingLength of stayGastrointestinal infectionsHospitalized childrenTesting ratesUtilization outcomesPediatric Health Information System databaseHealth Information System databaseOverall testing rateCross-sectional studyStool studiesDiagnostic stewardshipAcute careChildren's HospitalInformation System databaseMAIN OUTCOMEHospitalInfectionIndividual hospitalsOutcomesSignificant differencesChildrenSystem databaseTesting group