Search

Background: Pediatric primary care well-child visits commonly result in referrals for occupational therapy. However, only a small percentage of children under age three, at risk for developmental delays, receive an intervention. Healthcare providers’ limited knowledge and perception of occupational therapy and interprofessional collaboration may cause referral barriers. Pediatric medical residency education offers opportunities to impart information about available resources and benefits of early occupational therapy intervention and interprofessional collaboration through game-based simulations (virtual escape room). This pilot study explored the effects of participating in a virtual escape room simulation on pediatric medical residents’ knowledge and perception of occupational therapy's importance and treatment value, interprofessional collaboration, and likeliness to refer clients to occupational therapy. Methods: A three-hour educational activity, including a one-hour lecture, one-hour virtual escape room simulation, and one-hour debriefing, were measured using a pre-post survey study design completed by first-year postgraduate pediatric medical residents (n=6) as part of their pediatric residency orientation. Post-surveys also included a participant satisfaction questionnaire. Results: No significant difference was found in the pre-post-survey of knowledge and perception toward occupational therapy and interprofessional collaboration using the Wilcoxon Signed-Rank testing. However, using descriptive data, pre-post-survey responses to three statements regarding attitude toward occupational therapy revealed improved positive responses. Descriptive statistics were calculated, and the mean score for six statements regarding participant satisfaction was 4.83 using a five-point Likert scale, with 0 indicating low levels and 5 indicating high levels of satisfaction. Conclusion: Although the small sample size may account for no significant difference in knowledge and perception, descriptive analysis of this educational activity’s components revealed an improvement in pediatric medical residents’ perception of occupational therapy as an important healthcare profession, the profession’s overall value, and potential future referrals for services. These findings suggest that medical education simulations may improve residents’ knowledge and perception of interprofessional collaboration and inclusion of occupational therapists in primary care well-child visits, especially with early intervention. In addition, participant satisfaction with the escape room simulation was high overall.

Communication failures are a leading cause of adverse events, including sentinel events, in health care. Lapses in communication arise in a variety of healthcare settings and between all clinical provider types. Handoffs are conducted to ensure safe transfer of patient information from one provider to another. Handoffs are a form of communication that involves the transfer and acceptance of patient information and responsibility between providers. This chapter provides an overview of the history of handoffs, handoff education, and standardized models of handoffs. A patient vignette will provide a basis to examine potential pitfalls that should be considered when handoffs intersect the inter-professional team.

OBJECTIVE: To evaluate whether extremely low gestational age neonates (ELGANs) randomized to erythropoietin have better or worse kidney-related outcomes during hospitalization and at 22–26 months corrected gestational age (cGA) compared with those randomized to placebo. STUDY DESIGN: We performed an ancillary study to a multicenter double-blind, placebo-controlled randomized clinical trial of erythropoietin in ELGANs. RESULTS: The prevalence of severe (stage 2 or 3) acute kidney injury (AKI) was 18.2%. We did not find a statistically significant difference between those randomized to erythropoietin vs. placebo for in-hospital primary (severe AKI) or secondary outcomes (any AKI and serum creatinine [SCr]/ cystatin C values at days 0, 7, 9 and 14). At 22–26 months cGA, 16% of the cohort had an estimated glomerular filtration rate (eGFR) 30 mg/g, 23% had a systolic blood pressure (SBP) >95(th) percentile for age, and 40% had a diastolic blood pressure (DBP) >95(th) percentile for age. SBP >90(th) percentile occurred less often among recipients of erythropoietin (p95(th) percentile or DBP >90(th) or >95(th) percentiles. CONCLUSIONS: ELGANs have high rates of in-hospital AKI and kidney-related problems at 22–26 months cGA. Recombinant erythropoietin (rhEpo) may protect ELGANs against long-term elevated SBP, but does not appear to protect from AKI, low eGFR, albuminuria or elevated DBP at 22–26 months cGA.