Evidence map›Paper›PMID 29705118›Full record

ArticleThe Journal of pediatrics2018

Multi-Stakeholder Informed Guidelines for Direct Admission of Children to Hospital.

JoAnna K Leyenaar, Megan Shevenell, Paul A Rizzo, Vanessa L Hill, Peter K Lindenauer

Abstract read
In one paragraph

Article in The Journal of pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

JoAnna K LeyenaarDepartment of Pediatrics , The Dartmouth Institute For Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH; Graduate Program in Clinical and Translational Science, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA. Electronic address: joanna.k.leyenaar@hitchcock.org.
Megan ShevenellDepartment of Pediatrics , The Dartmouth Institute For Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH; Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA.
Paul A RizzoUniversity of Massachusetts Medical School, Worcester, MA.
Vanessa L HillDepartment of Pediatrics, Baylor College of Medicine, San Antonio, TX.
Peter K LindenauerInstititute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School, Springfield, MA; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.

Funding

Tufts Clinical and Translational Research InstituteUL1TR001064 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2013 to 2017
$26.4M
Research and Mentoring in Comparative Effectiveness and Implementation ScienceK24HL132008 · NHLBI · BAYSTATE MEDICAL CENTER, INC. · PI LINDENAUER, PETER KYLE · 2016 to 2020
$574k
Evaluating the safety and effectiveness of pediatric direct admissions to hospitalK08HS024133 · AHRQ · TUFTS MEDICAL CENTER · PI LEYENAAR, JOANNA · 2015 to 2017
$436k
AHRQ HHS K08 HS024133NCATS NIH HHS UL1 TR001064NHLBI NIH HHS K24 HL132008
6 · The paper itself

Abstract

objectivesTo develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes. STUDY

designWe conducted deliberative discussions at 1 children's hospital and 2 community hospitals, engaging parents of hospitalized children and inpatient, outpatient, and emergency department physicians and nurses to identify shared and dissenting perspectives regarding direct admission processes and outcomes. Discussions were audio-recorded, professionally transcribed, and analyzed using a general inductive approach. We then convened a national panel to prioritize guideline components and outcome measures using a RAND/UCLA Modified Delphi approach.

resultsForty-eight stakeholders participated in 6 deliberative discussions. Emergent themes related to effective multistakeholder communication, resources needed for high quality direct admissions, written direct admission guidelines, including criteria to identify children appropriate for and inappropriate for direct admission, and families' needs. Building on these themes, Delphi panelists endorsed 71 guideline components as both appropriate and necessary at children's hospitals and community hospitals and 13 outcomes to evaluate hospital admission systems. Guideline components include (1) pre-admission communication, (2) written guidelines, (3) hospital resources to optimize direct admission processes, (4) special considerations for pediatric populations that may be at particular risk of nosocomial infection and/or stress in emergency departments, (5) communication with families referred for direct admission, and (6) quality reviews to evaluate admission systems.

conclusionsThese direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration.

Indexed as

Attitude of Health PersonnelPatient AdmissionChildHospitals, CommunityHospitals, PediatricHumansOutcome and Process Assessment, Health CarePractice Guidelines as TopicStakeholder Participationcare coordinationchildrenhospitalizationportal of entry

Identifiers

PMID29705118
PMCPMC6086373

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.