Pediatric Hospital Medicine

Preface

T he extraordinary duty and privilege to care for hospitalized chil dren confers a tremendous responsibility. That responsibility includes providing evidence-based medical management and assurance that our patients receive the highest value health care. What does “high-value care” mean? To provide high-value care means to provide “the best care possible, efficiently using resources and providing optimal results for each patient.” 1 A reflection on the transformation of health care over the last 50 years inspired us to pub lish this book. As health care expenditure in the United States has significantly risen year over year, our diagnostic and therapeutic interventions must have the highest impact on our patients’ outcomes. This requires care ful consideration of procedures, treatment, and practice behaviors not proven to meaningfully affect patient outcomes. The conversations surrounding high-value intervention strategies with a focus on enhanced patient safety have increased over the past 23 years since the seminal “To Err Is Human” publication by the Insti tute of Medicine. 2 Many researchers have studied the value of routine patient interventions. Their studies have progressively found ways to deliver care in an efficient and effective way without pursuing unneces sary diagnostic tests or treatments. The field of Pediatric Hospital Medicine is privileged to have excep tional innovators in approaching patient care. These approaches have normalized the adoption of high-value care and avoidance of unneces sary diagnostic tests and treatments, both of which are strongly sup ported by over 20 years of robust research-based evidence. The authors and editors of this book are empowered stewards of high-value care. We have instilled high-value care into the curricula of our Pediatrics residency and Pediatric Hospital Medicine fellow ship programs. During patient rounds at our Children’s Hospital, the value of diagnostic tests and therapeutic interventions is deliberately and consistently discussed. The focus of these conversations is to

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