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Pediatrics is an ever-evolving field, and clinicians focused on clinical care, including pediatric hospital medicine providers, are in an ideal position to develop research projects that advance evidence-based practice. However, clinical providers get pulled away from their research to deliver high-quality education and care at the bedside to children and families. The challenges of balancing these important goals are ones most faculty will face their entire career. This is most difficult for faculty taking on their first project, as they have yet to refine their research skills, learn their various institutional resources, and build a research team. The purpose of our manuscript is to offer 10 reflections to consider when developing your first research project. We intentionally focused on concepts we felt were highly relevant to first research project experiences. Our goal is to motivate talented clinicians and encourage the development of a solid project foundation to avoid the various pitfalls we have experienced., (Copyright © 2024 by the American Academy of Pediatrics.)

The development of successful educational scholarship, either curricula or medical education research, is vital in ensuring that the field of medical education continues to evolve. Fostering the skills of medical educators in conducting high-quality educational research is essential to this process because publishing such research helps to disseminate best educational practices to the medical community at large. Unfortunately, developing rigorous medical education research can be challenging for pediatric hospitalists within busy clinical settings. In this article, we aim to discuss key principles and frameworks for curricular development as well as offer guidance in transforming a curriculum into a scholarly medical education research product for pediatric hospital medicine providers., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Objective: Hospitals that care for children face unique barriers in electronic medical records (EMR) use that may affect their ability to meaningfully use EMR. The purpose of this study was to investigate hospitals that care for children, both freestanding and adult hospitals with children's services, to determine progress toward advanced stages of EMR use., Methods: The American Hospital Association survey described hospitals across the United States. Healthcare Information and Management Systems Society 2006 and 2010 databases identified hospitals' EMR use. EMR stage was classified according to previous studies. Multivariable analysis was used to determine independent predictors of EMR use., Results: The analysis included 2794 hospitals. During the study time frame, a significant increase occurred for hospitals moving into any stage of EMR in adult hospitals with children's services (47% to 75%; P < .001), while improvements for freestanding children's hospitals were modest at best (46% to 59%; P = .3). Conversely, freestanding children's hospitals had the largest gain in advance stage 3 adoption (6% to 39%; P < .001) compared to adult hospitals with children's services (6% to 23%; P < .001). Freestanding children's hospitals were less likely to use pharmacy information systems but more likely to use computerized provider order entry., Conclusions: In 2010, freestanding children's hospitals had the highest percentage use of advanced stage EMR (39%), but the lowest improvements in percentage of hospitals entering into any stage of adoption over the study period. This trend created a digital divide among freestanding children's hospitals that may improve with pediatric-specific electronic medication management products., (Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Objective: Electronic medical record (EMR) systems are costly for hospitals to implement and maintain, and the effects of EMR on the cost of care for inpatient pediatrics remain unknown. Our objective was to determine whether delivering care with advanced-stage EMR was associated with a decreased cost per case in a national sample of hospitalized children., Methods: The Healthcare Cost and Utilization Project Kids Inpatient Dataset 2009 identified pediatric discharges. The Healthcare Information and Management Systems Society 2009 database identified hospitals' EMR use. EMR was classified into 3 stages, with advanced-stage 3 EMR including automation of ancillary services, automation of nursing workflow, computerized provider order entry, and clinical decision support. Multivariable linear regression was used to determine the independent effect of advanced-stage EMR on cost per case. Propensity score adjustment was included to control for nonrandom assignment of EMR use., Results: This analysis included 4,605,454 weighted discharges. EMR use by hospitals that care for children was common: 24% for stage 1, 23% stage 2, and 32% advanced stage 3. The multivariable model demonstrated that advanced stage EMR was associated with an average 7% greater cost per case ($146 per discharge)., Conclusions: The care of children across the United States with EMRs may create a safer health care system but is not associated with inpatient cost savings. In fact our primary analysis shows a 7% additional cost per case. This finding is contrary to predicted savings and may represent an added barrier in the adoption of EMR for inpatient pediatrics., (Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

The pediatric hospitalists in South Carolina at all three academic centers have expanded their clinical role by acting as referral physicians during a patient's hospital stay for surgeons, subspecialists, and/or primary care providers. In addition they have taken on the challenge of improving quality of care by offering clinical services, such as palliative care and consults, and are serving as the leaders for hospital system focus on quality improvement including improved patient safety. Specific recognition of pediatric hospitalists and hospitalists in general as a subspecialty is moving forward. Recently, the American Board of Internal Medicine approved the creation of a certificate for hospitalists in internal medicine and there are numerous pediatric hospitalist fellowships. Nationally, multiple societies have formed for this growing group of new physicians including the American Academy of Pediatrics Section on Hospital Medicine, Society of Hospital Medicine Section for Pediatric Hospitalists, and the Ambulatory Pediatric Associations Section on Pediatric Hospitalists. While it may be thought that hospitalists are merely generalists that work in the hospital and therefore should not be considered a separate group, hospitalists have a narrower focus that allows them to achieve better length of stay with lower costs and potentially improve the quality and safety of inpatient care as demonstrated in the studies referenced in this essay. Along with narrower focus the increased experience of treating inpatient illness and increased in-hospital availability contribute to the benefits described for hospitalist programs. Whether hospitalists will succeed as outlined above and how this group will function within our South Carolina healthcare system is up to the local leaders and state policy makers. Dr Carolyn Clancy, the Director of AHRQ pointed out in her Keynote Address to the Society of Hospital Medicine in May 2006 that "we will need you to expand 2 or 3 times to address this issue of quality". We make the following recommendations to incorporate these potentially beneficial systems: 1) Implemented hospital systems should follow the guidelines in the April 2005 Pediatrics policy statement. It is essential that systems be voluntary and private physicians reserve the right to admit to the hospital since many office based pediatricians have the skills and desire to continue inpatient care. 2) Medicaid and private providers should recognize the safety net function of hospitalist programs and the increasing complexity and acuity of pediatric inpatients and should reimburse pediatric inpatient care at or above Medicare rates to insure that hospitalist programs are financially sustainable. 3) Hospitalists should act as leaders in safety and quality initiatives including the use of evidence-based practice. 4) Implementation of hospitalist programs should be done in collaboration with local physicians to insure success and acceptance. In summary, hospitalists programs are growing and defining new paradigms in the national healthcare system. The programs can offer numerous benefits to patients, hospitals, and payers.