Jean Athey’s research while affiliated with Baylor College of Medicine and other places

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Publications (17)


Practice guidelines and performance measures in emergency medical services for children
  • Article

May 2002

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11 Reads

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34 Citations

Annals of Emergency Medicine

Jean D Moody-Williams

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Robert O'Connor

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[...]

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Renee S Holleran

Practice guidelines and performance measures are critical elements of an effective quality improvement process for emergency medical services for children (EMSC). Practice guidelines address the clinical management of individual patients, and performance measures assess the quality of care delivered to a population. The public and private sectors have invested considerable resources in developing practice guidelines and performance measures to improve the quality of health care services. As organizations continue development efforts, health care professionals who are actively involved in emergency care must collaborate to develop guidelines that address the unique physiologic, psychologic, and cultural needs of children. The Emergency Medical Services for Children Managed Care Task Force recommended the development of a series of white papers to focus on issues related to practice guidelines and performance measures in EMSC. The Maternal and Child Health Bureau, Health Resources and Services Administration, the National Highway Traffic Safety Administration, and the Robert Wood Johnson Foundation jointly sponsored the project. The paper was developed by a panel selected from a pool of experts in managed care, quality improvement, and emergency medical services. After a review of the literature, the panelists met to discuss critical issues related to practice guidelines and performance measures in EMSC. The panelists developed recommendations that can serve as resources for managed care organizations, health care providers, professional associations, and governmental policy makers. The panel recognized the lack of nationally recognized pediatric emergency care guidelines and performance measures and called for immediate action in these areas.


Injury prevention and emergency medical services for children in a managed care environment

April 2000

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11 Reads

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15 Citations

Annals of Emergency Medicine

Each year, 1 in 5 US children receives medical care as a result of injury. Injuries are the leading cause of medical spending for children ages 5 to 21 years, accounting for more than 20% of hospital admissions and days spent in the hospital. Pediatric injuries become an important issue for managed care organizations because of concern for member safety and increasing medical costs related to treatment. Because effective prevention decreases health care consumption, injury prevention often costs less than treating injuries. Simple devices, such as bicycle helmets, smoke detectors, and child safety seats, help keep children safe and save money. Appropriate emergency care at the scene of an injury, poison control centers that dispense expert advice over the telephone, and triaged regional trauma systems improve the outcome and save money at the same time. This article continues the white paper series by the Emergency Medical Services for Children Managed Care Task Force.


Quality and accountability: Children's emergency services in a managed care environment

January 2000

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8 Reads

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5 Citations

Annals of Emergency Medicine

The fast pace of change in the health care system has sparked growing interest among purchasers, consumers, providers, health plans, and others in evaluating and improving the quality of health services. The Emergency Medical Services for Children Program's Managed Care Task Force recommended the development of a white paper to focus on issues related to quality and accountability in children's emergency medical services in a managed care environment. A literature review was conducted, and a panel reviewed and discussed relevant materials. The panelists then developed recommendations as a resource for managed care organizations, providers of care, professional associations, and federal, state, and local policymakers.


Emergency Medical Services for Children Managed Care White Paper Series: Introduction

January 2000

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7 Reads

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1 Citation

Annals of Emergency Medicine

The introduction of managed care principles profoundly changed the delivery of health care in the United States. The Emergency Medical Services for Children (EMSC) program has developed a series of white papers to address the impact of managed care on the emergency care system for children and adolescents. We hope that these white papers will focus discussions among managed care organizations, health care providers, and the public in ways that will lead to improvement in the system of care available to children and adolescents.


Twenty-four–Hour Access to Emergency Care for Children in Managed Care

January 2000

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17 Reads

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6 Citations

Annals of Emergency Medicine

Children's medical emergencies occur around the clock. In years past, the emergency department, open 24 hours a day, was a familiar site for treating these emergencies. However, in today's health care environment, the scenario can be more confusing. As many families move from a fee-for-service system into a managed care organization (MCO), they may be unclear about what they should do in an emergency involving their child. MCOs want to provide appropriate care, and at the same time, operate within a system designed to contain costs through the establishment of effective health care delivery systems. Providers of emergency services, including specialists in pediatric medicine and emergency medical services responders, also must contend with a different set of problems, including administrative entanglements and concerns about reimbursement for their services. This article continues the white paper series by the Emergency Medical Services for Children Managed Care Task Force.


Consensus report for regionalization of services for critically ill or injured children

January 2000

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17 Reads

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16 Citations

Critical Care Medicine

The care of critically ill children has become more complex and demanding. This document establishes recommendations for developing regionalized integration of the care of these children into the emergency medical services system, These recommendations were developed by pediatricians with expertise in pediatric critical care, transport, and emergency medicine from the Pediatric Section of the Society of Critical Care Medicine Task Force on Regionalization of Pediatric Critical Care and the Committee on Pediatric Emergency Medicine from the American Academy of Pediatrics. The document was developed from existing guidelines from a number of professional organizations (including the Society of Critical Care Medicine and the American Academy of Pediatrics), a thorough review of the literature, and expert consensus.


Quality and Accountability: Children’s Emergency Services in a Managed Care Environment

December 1999

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10 Reads

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6 Citations

Annals of Emergency Medicine

The fast pace of change in the health care system has sparked growing interest among purchasers, consumers, providers, health plans, and others in evaluating and improving the quality of health services. The Emergency Medical Services for Children Program’s Managed Care Task Force recommended the development of a white paper to focus on issues related to quality and accountability in children’s emergency medical services in a managed care environment. A literature review was conducted, and a panel reviewed and discussed relevant materials. The panelists then developed recommendations as a resource for managed care organizations, providers of care, professional associations, and federal, state, and local policymakers. [Moody-Williams JD, Dawson D, Miller DR, Schafermeyer RW, Wright J, Athey J: Quality and accountability: Children’s emergency services in a managed care environment. Ann Emerg Med December 1999;34:753-760.]


Pediatric Care Recommendations for Freestanding Urgent Care Facilities

May 1999

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11 Reads

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4 Citations

Pediatrics

Freestanding urgent care centers are increasing as a source of after- hours pediatric care. These facilities may be used as an alternative to hospital emergency departments for the care and stabilization of serious and critically ill and injured children. The purpose of this policy statement is to provide recommendations for assuring appropriate stabilization in pediatric emergency situations and timely transfer to a hospital for definitive care when necessary.


The role of the pediatrician in rural EMSC
  • Article
  • Full-text available

May 1998

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47 Reads

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3 Citations

Pediatrics

This Policy Statement was revised. See https://doi.org/10.1542/peds.2012-2547 In rural America pediatricians can play a key role in the development, implementation, and ongoing supervision of emergency medical services for children (EMSC). Often the only pediatric resource for a large region, rural access pediatricians are more likely to treat pediatric emergencies in their own offices, and are a vital resource for rural physicians, or other rural health care professionals (physician assistants, nurse practitioners), and emergency medical technicians (EMTs) to improve system-wide EMSC by providing education about issues from prevention to rehabilitation, technical assistance in protocol writing, hospital care, and data accumulation, and as advocates for community and state legislation to support the goals of EMSC.

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The emergency physician and the office-based pediatrician: An EMSC team

May 1998

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4 Reads

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1 Citation

Pediatrics

In a quality and cost-conscious health care environment, the pediatrician and emergency physician must work as a team. This statement clarifies important issues of this relationship, including coordination of patient care, communication between clinicians, provision of continuity care, and responsibility for quality emergency care.


Citations (9)


... appropriate-sized oral airway, appropriate-sized facemask, paediatric stylet, paediatric bougie, paediatric ambubag, appropriate-sized laryngoscope blade, nasogastric (NG) tube, suction machine with suction tube, defibrillator, intravenous (IV) cannula with set, urinary catheter and small-sized syringes. In addition to those equipments, monitors that should be prepared during the preoperative period were, puls oximetry, blood pressure cuff, three lead electrocardiograph (ECG), capnography, temperature monitoring probe and stethoscope [9,10] . Even though the standards have seated the minimum paediatric anaesthesia equipments and monitors that should be prepared during the preoperative period, this study setup has been practiced poorly. ...

Reference:

The preparedness of preoperative anesthesia equipment's and monitors for pediatric patients
Guidelines for pediatric emergency care facilities
  • Citing Article
  • January 1995

... Earlier American Red Cross and the American Heart Association recommended back slaps, and chest thrusts with the infant positioned in a head-down position for choking. [10] Heimlich and Patrick challenged these recommendations as being ineffective and dangerous. [11] Abdominal thrusts (Heimlich maneuver) were recommended for children older than 1 year. ...

First aid for the choking child
  • Citing Article
  • January 1993

... Concurrently, there was a proliferation of guidelines to support the preparedness of prehospital and emergency department personnel. Pre-hospital curriculum and equipment lists were established, recommendations were made and the states developed various methods to address the complexity of providing for sick and injured children (ACEP, 1998;Seidel et al., 1996). A study published in 2001 by the Consumer Product Safety Commission, on behalf of the Health Resource and Services Administration's (HRSA) Maternal Child Health Bureau's Emergency Medical Services for Children Program (EMSC), concluded that emergent and critical care of children was poorly integrated and regionalized. ...

Guidelines for pediatric equipment and supplies for basic and advanced life support ambulances
  • Citing Article
  • December 1996

Pediatric Emergency Care

... Regionalization of medical care directs patients with specific high-risk conditions to designated hospitals with higher casevolumes. [1][2][3] The rationale is based upon evidence demonstrating lower mortality rates among hospitals providing services for the highest case-volumes of critically ill patients, 4-8 yet the mechanisms have been debated ever since Luft et al 9 published their landmark 1979 article. Many researchers consider case-volume as a proxy for quality of care. ...

Consensus report for regionalization of services for critically ill or injured children
  • Citing Article
  • January 2000

Critical Care Medicine

... Furthermore, oxyhemoglobin desaturation with CH sedation has been reported to occur more frequently in term infants with younger PNA and younger preterm infants with younger PMA. 13 The first reported recommendation of using physical restraint, such as cloth, for medical purpose was in 1997 by AAP. 14 Since then, brain MRI in non-sedated, swaddled infants placed in warm sheets has been reported in a number of articles. 15,16 In line with this, in 2004, the Scottish Intercollegiate Guidelines ...

The Use of Physical Restraint Interventions for Children and Adolescents in the Acute Care Setting
  • Citing Article
  • March 1997

Pediatrics

... The National Association of EMS Officials (NASEMSO) created an EMS Education Toolkit for Pediatrics, aimed "to improve evaluation and performance related to pediatric skills competency" based on the National EMS Educational Standards [15]. EMS educators also maintain that regular cognitive and psychomotor learning opportunities be provided to paramedics for pediatric encounters [16]. Despite growing efforts to improve prehospital care for children, current training requirements and pediatric encounter exposure for EMS systems may vary across states or jurisdictions [9,17]. ...

Education of Out-of-Hospital Emergency Medical Personnel in Pediatrics: Report of a National Task Force
  • Citing Article
  • January 1998

Annals of Emergency Medicine

... mistreatment, suicide, running away, violence and domestic injury. This vulnerable population may suffer more than any other under a system that imposes severe restrictions [29,51]. Finally, there are too few quality evaluation programs for emergency services: Managed Care encourages hospital care evaluation, but this has had little impact on emergency services. ...

Twenty-four–Hour Access to Emergency Care for Children in Managed Care
  • Citing Article
  • January 2000

Annals of Emergency Medicine

... Mantendo a visão sistemática das diferentes peculiaridades quanto à abordagem das vias aéreas, ventilação, circulação com controle de hemorragias, exame minineurológico e exposição, além do exame secundário, com o preparo do transporte préhospitalar e inter-hospitalar quando necessário, serão esperados melhores resultados. grupo de condições que exige atenção médica, além de gerar mais de 20% das admissões e dias de internação hospitalar 9 . ...

Injury prevention and emergency medical services for children in a managed care environment
  • Citing Article
  • April 2000

Annals of Emergency Medicine

... Such EDs have limited access to pediatric specialists and low patient volumes, making it difficult to maintain high-quality pediatric care. [1][2][3][4][5][6][7][8][9] One solution to address this shortage is the use of pediatric tele-emergency services, which uses telemedicine to bring pediatric specialty services to nonchildren hospital EDs. Although pediatric tele-emergency services have been increasingly used to provide consultations for pediatric patients in EDs, little is known about how general emergency medicine (GEM) physicians' perceive the user experience and clinical impact of telemedicine. ...

Practice guidelines and performance measures in emergency medical services for children
  • Citing Article
  • May 2002

Annals of Emergency Medicine