2024
Disparities 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-centeredPhlebotomy‐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 groups
2023
Prevalence 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
2022
Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic.
Aronson P, Kerns E, Jennings B, Magee S, Wang M, McDaniel C. Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic. Pediatrics 2022, 150 PMID: 36353853, DOI: 10.1542/peds.2022-059235.Peer-Reviewed Original ResearchConceptsUrinary tract infectionInvasive bacterial infectionsCOVID-19 prevalenceFebrile infantsOdds of UTIPrevalence of UTIBacterial infectionsMulticenter cross-sectional studyEmergency department visitsMonths of presentationCoronavirus disease 2019 (COVID-19) pandemicCross-sectional studyDisease 2019 pandemicUTI prevalenceTract infectionsBacterial meningitisDepartment visitsLower oddsPrepandemic levelsInfantsInfants 8MeningitisBacteremiaLogistic regressionPrevalenceInjury-Related Pediatric Emergency Department Visits in the First Year of COVID-19.
Wells J, Rodean J, Cook L, Sills M, Neuman M, Kornblith A, Jain S, Hirsch A, Goyal M, Fleegler E, DeLaroche A, Aronson P, Leonard J. Injury-Related Pediatric Emergency Department Visits in the First Year of COVID-19. Pediatrics 2022, 150 PMID: 35836331, DOI: 10.1542/peds.2021-054545.Peer-Reviewed Original ResearchConceptsInjury-related visitsInjury-related ED visitsHospital emergency departmentEmergency departmentED visitsSARS-CoV-2 pandemic periodAcute respiratory syndrome coronavirus 2 pandemicSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemicChildren's hospital emergency departmentPediatric Health Information SystemUnited States children's hospitalsPrimary discharge diagnosisMechanism of injurySprains/strainsPediatric emergency departmentCoronavirus 2 pandemicCross-sectional studySARS-CoV-2 pandemicFirst yearPatient characteristicsChildren's HospitalDischarge diagnosisInjury patternsInjury typeAdministrative databasesDisparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol
Gutman C, Lion K, Aronson P, Fisher C, Bylund C, McFarlane A, Lou X, Patterson M, Lababidi A, Fernandez R. Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol. BMJ Open 2022, 12: e063611. PMID: 36127098, PMCID: PMC9490627, DOI: 10.1136/bmjopen-2022-063611.Peer-Reviewed Original ResearchConceptsLow-risk febrile infantsFebrile infantsEmergency departmentClinical carePediatric Emergency Medicine Collaborative Research CommitteeFlorida Institutional Review BoardLocal institutional review board approvalPediatric ED physiciansInstitutional review board approvalMultivariable logistic regressionCross-sectional studyPhysician-patient communicationReview board approvalClinical guideline implementationMethods study protocolInstitutional review boardMulticenter analysisPrimary outcomeED physiciansPhysician assessmentRecommended careGuideline implementationLumbar punctureStudy protocolEmergency settingVariation in bacterial pneumonia diagnoses and outcomes among children hospitalized with lower respiratory tract infections
Cotter J, Hall M, Shah S, Molloy M, Markham J, Aronson P, Stephens J, Steiner M, McCoy E, Collins M, Tchou M. Variation in bacterial pneumonia diagnoses and outcomes among children hospitalized with lower respiratory tract infections. Journal Of Hospital Medicine 2022, 17: 872-879. PMID: 35946482, PMCID: PMC11366396, DOI: 10.1002/jhm.12940.Peer-Reviewed Original ResearchConceptsBacterial community-acquired pneumoniaLower respiratory tract infectionsCommunity-acquired pneumoniaRespiratory tract infectionsProportion of childrenTract infectionsDiagnosis groupsMulticenter cross-sectional studyLength of stayCross-sectional studyCause revisitsClinical outcomesBlood testsChildren's HospitalViral causeCaP diagnosisChest radiographsMAIN OUTCOMEMultivariable regressionPneumonia diagnosisHospitalDiagnosisOutcomesReadmissionSignificant differences
2018
Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments
Woll C, Neuman MI, Pruitt CM, Wang ME, Shapiro ED, Shah SS, McCulloh RJ, Nigrovic LE, Desai S, DePorre AG, Leazer RC, Marble RD, Balamuth F, Feldman EA, Sartori LF, Browning WL, Aronson PL, Collaborative F, Alpern E, Hayes K, Lee B, Lumb C, Mitchell C, Peaper D, Rooholamini S, Shin S, Williams D. Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments. The Journal Of Pediatrics 2018, 200: 210-217.e1. PMID: 29784512, PMCID: PMC6109608, DOI: 10.1016/j.jpeds.2018.04.033.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsThird-generation cephalosporinsMicrobiology laboratory databaseEmergency departmentBacterial infectionsBacterial meningitisPediatric emergency departmentCombination of ampicillinAntimicrobial treatment regimenCross-sectional studyGroup B streptococciElectronic medical record systemEmpiric treatmentMedical record systemTreatment regimenChildren's HospitalMost infantsMedical recordsB streptococciCerebrospinal fluidCommon pathogensInfantsAntimicrobial susceptibilityDay oldsInfection
2015
Association of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age
Aronson PL, Thurm C, Williams DJ, Nigrovic LE, Alpern ER, Tieder JS, Shah SS, McCulloh RJ, Balamuth F, Schondelmeyer AC, Alessandrini EA, Browning WL, Myers AL, Neuman MI, Collaborative F. Association of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age. Journal Of Hospital Medicine 2015, 10: 358-365. PMID: 25684689, PMCID: PMC4456211, DOI: 10.1002/jhm.2329.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBlood Chemical AnalysisCeftriaxoneCerebrospinal FluidCost ControlCross-Sectional StudiesEmergency Service, HospitalFeverGuideline AdherenceHealth Care SurveysHealth Information SystemsHospitals, PediatricHumansInfantInfant, NewbornPractice Guidelines as TopicRetrospective StudiesUnited StatesUrinalysisConceptsClinical practice guidelinesCeftriaxone useCPG recommendationsInfants 29CSF testingHealthcare costsED dischargeFebrile infantsPractice guidelinesInstitutional clinical practice guidelinePediatric Health Information SystemRetrospective cross-sectional studyCerebrospinal fluid testingEmergency department managementCross-sectional studyLower healthcare costsRate of urineDiagnosis of feverDays of ageED visitsPractice variationDepartment managementAge groupsHealth information systemsFluid testing