Approved Projects for Physicians with a Relationship with Nicklaus Children's Hospital

The following projects are currently approved for ABP Part 4 MOC Credit through the Portfolio Sponsorship Program. 
Unless otherwise stated, these projects are only available to physicians with a relationship to Nicklaus Children's Hospital

Project Title:
Decreasing the Oversuse of CXR in Children (3y-18y) with Uncomplicated Asthma

Project Expiration Date: June 30; 2018
Approving Board: ABP
Project Description:

Preliminary data from 2016 show that there is overutilization of CXR in the Nicklaus Children’s Hospital Emergency Department (ED) and Urgent Care Centers (UCCs). The numbers of ordered CXR in cases of uncomplicated asthma are significantly higher than the national benchmark. This leads to increased exposure of children to unnecessary radiation and increased cost of care. Despite the presence of Asthma national Guidelines, there is lack of adherence to the guidelines. This could be due to multiple factors including: (1) Lack of education of providers (2) Perceived expectations of parents by the providers and (3) other historic practice patterns (4) Fear of missing diagnosis (5) Fear of litigation. This project aims at decreasing the number of CXR ordered for children with uncomplicated asthma.

To participate, Contact the Project Leader; Dr. Mario Reyes


Project Title:
Decreasing the Oversuse of CXR in Young Children (1m - 1 y) with Uncomplicated Bronchiolitis

Project Expiration Date: June 30; 2018
Approving Board: ABP
Project Description:

Preliminary data from 2016 show that there is overutilization of CXR in the Nicklaus Children’s Hospital Emergency Department (ED) and Urgent Care Centers (UCCs). The numbers of ordered CXR in cases of uncomplicated bronchiolitis are significantly higher than the national benchmark. This leads to increased exposure of children to unnecessary radiation and increased cost of care. Despite the presence of new AAP Bronchiolitis Guidelines since 2015, there is lack of adherence to the guidelines. This could be due to multiple factors including: (1) Lack of education of providers (2) Perceived expectations of parents by the providers and (3) other historic practice patterns (4) Fear of missing diagnosis (5) Fear of litigation . The aim of this project is to decrease the number of CXR ordered in patients with uncomplicated bronchiolitis between 1m-1year of age. This project is only opened to hospital physicians staff.

To participate, Contact the Project Leader; Dr. Mario Reyes


Project Title:
Improving Documentation of Newborn Screen in a Free Standing NICU

Project Expiration Date: December 31; 2015
Approving Board: ABP
Project Description:

Newborn Screening (NBS) is a highly successful public health program that requires timely confirmatory testing, diagnosis, and clinical management so that optimal long-term outcomes can be achieved. NICU population represents a challenge for the eddcative implementation of NBS. Contrary to infants admitted to the regular newborn nursery, who are born healthy, full-term and > 2500g; infants admitted to the NICU are sick and/or premature and/or low birth weight with a prolonged hospital stay. The interventions routinely used in these settings such as blood transfusions, NPO, and TPN solutions have the potential to affect the NBS results and may lead to delay in diagnosis and clinical management. Our analysis of NBS documentation in the NICU in January 2015 revealed a 35% rate of documentation of NBS obtained during hospitalization. The aim of thsi project is to improve the NBS documentation in the NICU to 90% over the next 12 months.
To participate, Contact the Project Leader; Dr. Magaly Diaz-Barbosa


Project Title:
Improvement in the Safe and Efficient Management of Acute Scrotal/Testicular Pain

Project Expiration Date: May 1; 2017
Approving Board: ABP
Project Description:

Delays in the definitive diagnosis of testicular torsion can lead to poor outcomes and loss of function. All members of the Emergency Department team may not recognize the acute and emergent nature of this condition. Baseline data indicate that there is room for improvement in the time from presentation to the ED until final U/S read and report. The goal of this project is to improve the time required between presentation to Nicklaus Children's Hospital ED and the time of definitive diagnosis for patients presenting with acute scrotal pain to rule out testicular torsion. An institutional standard pathway is created and the project will aim at increasing adherence to the standard pathway.
To participate, Contact the Project Leader; Dr. Jefry Biehler


Project Title:
Severe Sepsis Bundle Implementation at Nicklaus Children’s Hospital

Project Expiration Date: May 31; 2019
Approving Board: ABP
Project Description: 
Sepsis is a dangerous systemic infection that often leads to poor patient outcomes, including mortality. Severe sepsis is a significant problem among acutely ill children. A bundle for recognition, initiation and continuation of treatment of severe sepsis based on national guidelines has been created at Nicklaus Children's Hospital but not yet implemented. The goal of the project is to Implement severe sepsis bundle at Nicklaus Children's Hospital thereby improve sepsis-related outcomes.
To participate, Contact the Project Leader; Dr. Bala Totapally