US News Pediatric Survey



SECTION C: PEDIATRIC ENDOCRINOLOGY Do you have a Pediatric Endocrinology program?Yes No – Skip to Section DWhen responding to questions in this section, your hospital must consult with the chief of service (or equivalent) of your Pediatric Endocrinology program to ensure that answers are accurate and consistent with both the care delivered and the intent of the survey.As data are reviewed, U.S. News may have questions about responses to individual questions or about an entire submission. To ensure communication with the appropriate clinical leader, please provide the following information about the chief of service (or equivalent) for your Pediatric Endocrinology program.Full name:Title:Email:Preferred phone:REQUIRED: IF NAME, TITLE, EMAIL, OR PHONE=BLANK, DISPLAY: “A response is required for [Name/Title/Email/Phone] prior to submitting the survey. Click “OK” to continue with the survey and answer this question later. Click “Cancel” to provide a response to this question now.”C1.1Are you submitting jointly with a Pediatric Endocrinology program at another hospital?Yes – Go to Question C1.2 No – Skip to Question C2C1.2If yes, what is the name of the Pediatric Endocrinology program you are reportingly jointly with? Please note that joint submissions must be reviewed and approved before they are allowed. Before submitting your survey, please contact RTI at PediatricHospSurvey@ to discuss your joint submission request unless you already have received permission to jointly submit data in this specialty. As noted in the instructions for joint reporting, if you are granted permission, only the primary hospital in the joint reporting relationship will be allowed to report data for this specialty.Please indicate the total number of attending/on-staff physicians (excluding fellows) who are currently members of the medical staff in your Pediatric Endocrinology program in the following categories. For each category, please also indicate the total number of full-time equivalents (FTEs) devoted to clinical care for Pediatric Endocrinology patients. [If none, please enter 0.]Total PhysiciansClinical FTEsa.Pediatric endocrinologists (board certified/board eligible by the American Board of Pediatrics with subspecialty certification in pediatric endocrinology) ________________b.Other attending/on-staff physicians (include all other attending/on-staff physicians who are not subspecialty certified/ board eligible in pediatric endocrinology) ________________VALIDATE:IF C2x1 IS NOT A WHOLE NUMBER, DISPLAY: “C2x (Total Physicians): Please enter a whole number (no decimals).”Note: The preceding questions are used to determine eligibility for Pediatric Endocrinology. If you leave any part of these questions blank, your hospital will be considered ineligible for the rankings in Pediatric Endocrinology.Please indicate the total number of nurse practitioners and physician assistants who currently work in or directly support your Pediatric Endocrinology program. For each category, please indicate the total number of full-time equivalents (FTEs) devoted to clinical care of Pediatric Endocrinology patients. [If none, please enter 0.]Total StaffClinical FTEsa.Nurse practitioners________________b.Physician assistants ________________VALIDATE:IF C3x1 IS NOT A WHOLE NUMBER, DISPLAY: “C3x (Total Staff): Please enter a whole number (no decimals).”For each category of staff, please indicate the total number of FTEs actually spent in outpatient clinical care of Pediatric Endocrinology patients, including Endocrinology testing. [Staff should be counted only in the highest category, for which they qualify.] [If none, please enter 0.]Outpatient FTEsa.BSN level RN FTEs ________b.MSN or equivalent level RN FTEs ________c.PhD or DNP level RN FTEs ________How many FTEs of the following healthcare staff provide diabetes education to patients in your Pediatric Endocrinology program? Of the staff identified in this question, how many FTEs currently have Certified Diabetes Educator (CDEs) certification? [If none, please enter 0.]FTEsFTEs with CDE certification a.Nurses __________b.Dietitians __________c.Others (e.g., Pharmacists, Social Workers, Psychologists) __________d.Certified exercise physiologist or Physical therapist __________VALIDATE:IF C5x2>C5x1, DISPLAY: “C5x: Number of staff with CDE certification cannot be greater than Number of staff.”Please indicate the number of fulltime equivalents (FTE) staff in each category below currently dedicated to the care of pediatric Endocrinology patients. [If none, please enter 0.]FTEa.Social workers _____b.Psychologists _____In the last calendar year, did the following healthcare staff provide on-site services to your Pediatric Endocrinology patients?YesNoa.Genetic counselors ○○b.Psychiatrist ○○c.Pharmacist ○○This question has been removed from the survey.Does your Pediatric Diabetes program provide the following services onsite?YesNoa.Written education protocol used to evaluate and prepare patients for use of an insulin pump ○○b.Certified pump educators (CPEs) who are members of your staff to provide pump training in house to patient families ○○c.Written education protocol used to evaluate and prepare patients for use of continuous glucose monitors (CGMs) ○○d.Certified CGM trainers who are members of your staff5 to provide CGM training to patient families ○○e.Written education protocol for families of new-onset diabetes patients ○○f.Formal diabetes education program for school nurses through a yearly school nurse education conference○○g.A specified RN or CDE who is responsible for advising and supporting schools in safe management of diabetes ○○Did your Pediatric Diabetes program staff (physicians, physician assistants, nurse practitioners, clinical nurses, and diabetes educators) take a leadership role in organizing and running a Diabetes Camp in the past year?YesNoDid any of your Pediatric Diabetes program staff (physicians, physician assistants, nurse practitioners, clinical nurses, or diabetes educators) take a leadership role in a formal advocacy effort supporting the rights of patients with diabetes with local, state, and/or federal government in the past year?YesNoHas your Pediatric Diabetes program hosted or been actively involved in organizing a diabetes-specific support group at your hospital or in your community in the last calendar year?YesNoHas your Pediatric Diabetes program hosted or been actively involved in organizing a diabetes-specific technology (pumps, CGM, social networking websites, diabetes apps, telemedicine) education program (“technology fair”) for your patients in the last calendar year?YesNoDid your diabetes education program have “recognition status” from the American Diabetes Association (ADA) or the American Association of Diabetes Educators (AADE) as of December 31, 2019?YesNoDoes your Diabetes Program administer a formal, written assessment of diabetes management knowledge after initial education and at least yearly thereafter?YesNoHow many times were diabetes patients on insulin therapy (see code list – patients must have diabetes diagnosis AND be treated with insulin) admitted as inpatients to other services (e.g., surgery, transplant, cystic fibrosis) in the last calendar year? (Do not include day surgery patients or observation patients who stay less than 24 hours). [If none, please enter 0.]______ Admissions of diabetes inpatients treated with insulin admitted to other services VALIDATE:IF C16 IS NOT A WHOLE NUMBER, DISPLAY: “C16: Please enter a whole number (no decimals).”SKIP LOGIC:IF C16 >0, ASK C16.1; ELSE, GO TO C17.C16.1How many of these admissions (from C16) were seen by a clinical member of your Pediatric Diabetes program for evaluation, assistance with patient management, or teaching (e.g., pump education, diet consultation, medication management, etc.)? [If none, please enter 0.]______Admissions seen by providers in the Pediatric Diabetes program VALIDATE:IF C16.1 IS NOT A WHOLE NUMBER, DISPLAY: “C16.1: Please enter a whole number (no decimals).”IF C16.1 > C16, DISPLAY: The number of admissions in C16.1 cannot be greater than the number of admissions in C16.In the past year, has your Pediatric Diabetes program provided a formal written transition program to prepare pediatric patients over a period of time (6 months or more) for the transition to an adult diabetes physician or program? YesNoWhat percentage of patients in your Pediatric Diabetes program received a brief written (or electronic) report of their diagnosis or findings and a treatment plan at the conclusion of their most recent inpatient treatment stay or outpatient visit?______ % of outpatients ______ % of inpatients VALIDATE: 0 ≤ C18x ≤ 100. ELSE DISPLAY: “C18x: Please enter a numeric value between 0 and 100.”Which of the following elements are always included in the summary given to patients at outpatient clinic visits in your Pediatric Diabetes program? Check all that plete insulin dosages (e.g., Basal dose/pump rates; bolus dosing parameters; fixed insulin doses) Blood glucose testing recommendations and record keeping recommendationsA1c value from today and/or percent of time “in range” (70 – 180 mg/dl) from at least 1 week of CGM data Next visit date and time Information on when and how to contact the Diabetes Center Referrals made for laboratory, ophthalmological, dental, mental health before the next visit Behavioral Goals None of the above Does your Pediatric Diabetes program have a clinical database of attributes of current, active diabetes patients that you use for quality assessment and improvement that would allow you to determine, for example, the mean and median value for the most recent outpatient Hemoglobin A1c for all active patients from 8-10 years of age with Type 1 diabetes (see code list)?YesNoDoes your institution have a written plan to review all inpatient insulin-related medication errors and adverse drug events that involves timely (within 3 days) notification of the Medical Director of Pediatric Diabetes?YesNoDoes your Pediatric Diabetes program have written consensus protocols or guidelines for the following?YesNoa.Glucagon minidose for families ○○b.Periodic screening for complications of diabetes in the outpatient clinic ○○c.Evaluation of hyperglycemia in critically ill inpatients (without baseline diabetes) ○○d.Outpatient management of type 2 diabetes patients ○○e.Outpatient management of “pre-diabetes” patients who typically have obesity and insulin resistance, which includes guidelines for screening for co-morbidities including hypertension, dyslipidemia, non-alcoholic steatohepatitis, orthopedic disease, and sleep apnea ○○Does your Pediatric Diabetes program review the care of all patients admitted with a primary diagnosis of diabetes including hypoglycemia, hyperglycemia, and/or DKA (see code list) with an interdisciplinary team including Pediatric Endocrinologists, Dietitians, Social Workers or Psychologists, and Diabetes Nurse Educators prior to discharge? YesNoThis question has been removed from the survey.Does your Pediatric Diabetes program have a regularly scheduled interdisciplinary care conference involving Pediatric Endocrinologists, Dietitians, Social Workers or Psychologists, and Diabetes Nurse Educators to discuss diabetes outpatients (see code list) with poor control (e.g., consistently elevated A1c and/or recurrent DKA, frequent severe hypoglycemia, etc.)?YesNo (Skip to C27)During the past calendar year, approximately how often did the interdisciplinary care conferences occur? Once or twice during the yearEvery two to three monthsOnce a monthTwice a monthOnce a weekNot ApplicableDo you have a written protocol for identifying “high risk” (e.g., high A1c and/or repeated DKA) patients and enrolling them in a special pathway (e.g., more frequent or more intense clinic visits) for their care?YesNoDoes your Pediatric Endocrinology program interact with your institution’s clinical laboratory or pathology service to review laboratory findings, problems and updates? On a regular basis (an established frequency or routine)As neededNever or not at allC28.1What was the total number of patient admissions/visits to your Pediatric Diabetes program that had each of the following primary diagnoses in the last calendar year? [Note that your numbers may include all pediatric patients seen for care that are < 18 years of age. If none, please enter 0.]Total patient admissions/visitsa. Outpatient visits with Type 1 diabetes (see code list) ________b. Outpatient visits with Type 2 diabetes (see code list) ________c. Inpatient admissions with Type 1 diabetes (see code list) admitted for diabetes-related causes (hyperglycemia, DKA,) ________d. Inpatient admissions with Type 2 diabetes (see code list) admitted for diabetes-related causes (hyperglycemia, DKA,) ________VALIDATE:IF C28.1x IS NOT A WHOLE NUMBER, DISPLAY: “C28.1x: Please enter a whole number (no decimals).”C28.2How many unique patients with a genetically confirmed (in the patient or the patient’s family member) form of genetic diabetes (e.g., maturity onset diabetes of the young (MODY) or neonatal diabetes mellitus (NDM)) were seen in outpatient clinic by providers in your Pediatric Diabetes program in the past calendar year by insurance type (private or commercial insurance versus Medicaid only)? [Note: The codes used for this question include a wide array of diagnoses beyond MODY. Please review cases identified when using these codes and only include those that meet the requirements for MODY (e.g., “Maturity onset diabetes mellitus in young, Maturity onset diabetes of youth, Maturity-onset diabetes of the young”)]______Unique private insurance patients seen with genetic forms of diabetes ______Unique Medicaid insurance patients seen with genetic forms of diabetes VALIDATE:IF C28.2x IS NOT A WHOLE NUMBER, DISPLAY: “C28.2x: Please enter a whole number (no decimals).”Do you ask at each diabetes outpatient clinic visit about the number of hospital admissions, emergency department visits, or urgent care visits since the last diabetes outpatient visit? [Note: To answer “yes” you must include admissions and visits at your hospital and at other facilities and offices from patient charts in your counts.]Yes No (Skip to C29.2)C29.1Does your EMR have a field (such as an Epic FlowSheet) to track the number of hospital admissions, emergency department visits, and urgent care visits since the last diabetes outpatient visit? To answer “yes” this must not be a free-text field.Yes NoC29.2 Indicate the number of unique primary diabetes care patients that are < 18 years of age in each of the following categories seen in your Pediatric Diabetes program by insurance type (private or commercial insurance versus Medicaid only). [If none, please enter 0.]When identifying data for your response to this question, please:Access or filter data to outpatient visits, inpatient records, or ER and urgent care visits (as requested in the questions below);Remove any patients with age > 18 on the date of the visit;Merge/join the ICD-10 code lists provided for each population of interest;Keep only patients with a date of diagnosis or initial visit date of more than 1 year ago; De-duplicate by unique patient identifier to obtain unique patient count; andFlag Medicaid / Private insurance category as payer type at last visit.Unique Private Insurance PatientsUnique Medicaid Patientsa. Primary diabetes care pediatric outpatients in your practice for over one year and seen 2 or more times in the last calendar year with Type 1 diabetes (see code list) ________________b. Primary diabetes care pediatric outpatients in your practice for over one year and seen 2 or more times in the last calendar year with Type 2 diabetes (see code list) ________________c. Number of unique patients in C29.2a admitted for diabetes-related causes (hypoglycemia, DKA)________________d. Number of unique patients in C29.2b admitted for diabetes-related causes (hypoglycemia, DKA) ________________e. Number of patients in C29.2a seen in emergency room or urgent care for diabetes-related causes (hypoglycemia, DKA) ________________f. Number of patients in C29.2b seen in emergency room or urgent care for diabetes-related causes (hypoglycemia, DKA) ________________VALIDATE:IF C29.2x IS NOT A WHOLE NUMBER, DISPLAY: “C29.2x: Please enter a whole number (no decimals).”IF C29.2x IS BLANK, DISPLAY: “C29.2x: If none, please enter 0.”IF C29.2c > C29.2a DISPLAY: “Type 1 patients admitted for diabetes-related causes (C29.2c) cannot be greater than total Type 1 primary diabetes care pediatric outpatients (C29.2a).”IF C29.2d > C29.2b, DISPLAY: “Type 2 patients admitted for diabetes-related causes (C29.2d) cannot be greater than total Type 2 primary diabetes care pediatric outpatients (C29.2b).”IF C29.2e > C29.2a, DISPLAY: “Type 1 patients seen in ER or urgent care (C29.2e) cannot be greater total Type 1 primary diabetes care pediatric outpatients (C29.2a).”IF C29.2f > C29.2b, DISPLAY: “Type 2 patients seen in ER or urgent care (C29.2f) cannot be greater than total Type 2 primary diabetes care pediatric outpatients (C29.2b).”SKIP LOGIC: IF C29.2a1 + C29.2a2 + C29.2b1 + C29.2b2 > 0, ASK C30 – C36. ELSE, GO TO C37.What percentage of all primary diabetes care patients (see C29.2a and C29.2b) that are < 18 years of age being treated by your Pediatric Endocrinology Program have had a face-to-face visit of the following type in the last calendar year?Percent of Patientsa. Medical Nutrition Therapy with nutritionist or a CDE________%b. Diabetes Education with a CDE or equivalent ________%c. Social Worker or Psychologist assessment ________%VALIDATE: 0 ≤ C30x ≤ 100. ELSE DISPLAY: “C30x: Please enter a numeric value between 0 and 100.”What percentage of primary diabetes care patients (see C29.2a and C29.2b) that are < 18 years of age seen in the last calendar year that meet the criteria described below had completed the following tests? [Notes: (1) We recommend that you consult your inpatient and outpatient EMR records as well as physician billing to determine whether each test occurred; if your hospital tracks these data in a local database, that may be consulted as well. (2) When submitting your survey, each hospital will be required to create and upload a deidentified table of patient data from your EMR or other records that shows the values for each requested element. The file should include a record identifier, the date of service (which can be month or quarter if needed) for any test or procedure listed, and the value of the information requested. If totals across a group of patients are requested to respond to the survey item, please also show your work in this file with totals and formulas displayed. This information will be used to check your responses to this question.]Type 1 diabetes (see C29.2a)Percent of Type 1 diabetes patients a. Percentage of primary Type 1 diabetes patients (see C29.2a) that had TSH documented in their patient medical chart at some point in the last two calendar years ________%b. Percentage of Type 1 diabetes patients (see C29.2a), who are >10 years of age, who have had a lipid profile performed in the last 5 calendar years ________%c. Percentage of Type 1 diabetes patients (see C29.2a), who are >10 years of age, with a duration of diabetes over 5 years, who have received a microalbuminuria screening in the past year ________%d. Percentage of Type 1 diabetes patients (see C29.2a), who are >10 years of age, with a duration of diabetes over 5 years, who have received a dilated retinal or non-mydriatic camera examination in the past two calendar years. A parent report of this evaluation including the month and year of the exam must be recorded in the medical record. ________%Type 2 diabetes (see C29.2b)Percent of Type 2 diabetes patientse. Percentage of Type 2 diabetes patients (see C29.2b) who have had a lipid profile performed in the last calendar year.________%f. Percentage of Type 2 patients (see C29.2b) who have had a microalbuminuria screening in the last calendar year.________%g. Percentage of Type 2 patients (see C29.2b) who have received a dilated retinal or non-mydriatic camera examination in the past 2 calendar years. A parent report of this evaluation including the month and year of the exam must be recorded in the medical record.________%VALIDATE: 0 ≤ C31x ≤ 100. ELSE DISPLAY: “C31x: Please enter a numeric value between 0 and 100.”Of the unique primary Type 1 diabetes care pediatric patients (see C29.2a) that are < 18 years of age who have been treated for the past 12 months or longer, what percentage were scheduled for and what percentage attended four or more diabetes outpatient clinic visits in the last calendar year? ________% Scheduled for 4 or more outpatient clinic visits ________% Attended 4 or more outpatient clinic visits VALIDATE: 0 ≤ C32x ≤ 100. ELSE DISPLAY: “C32x: Please enter a numeric value between 0 and 100.” IF C32b > C32a, DISPLAY: “C32: Please check your responses. The percent of patients that attended 4 or more visits cannot be greater than the percent of patients scheduled for 4 or more visits.”C32.1Of the unique primary Type 1 diabetes care pediatric patients (see C29.2a) that are < 18 years of age in your pediatric program, how many used a continuous glucose monitor (CGM) in the last calendar year by insurance type?________ Unique private insurance patients using CGM ________ Unique Medicaid patients using CGM VALIDATE:IF C32.1 IS NOT A WHOLE NUMBER, DISPLAY: “C32.1: Please enter a whole number (no decimals).”IF C32.1 > C29.2a DISPLAY: “Type 1 patients using CGM (C32.1) cannot be greater than total Type 1 primary diabetes care pediatric outpatients (C29.2a).”C32.2Of the patients reported in C32.1, how many documented interpretations of CGM readings (determined by chart review or CPT code 95251) did they have in the last calendar year associated with ambulatory visits by insurance type?________Number of documented interpretations for private insurance patients ________Number of documented interpretations for Medicaid patients VALIDATE:IF C32.2 IS NOT A WHOLE NUMBER, DISPLAY: “C32.2: Please enter a whole number (no decimals).”What percentage of the unique primary Type 1 diabetes care pediatric patients (as defined in question C29.2a) that are < 18 years of age were on an insulin pump in the last calendar year by insurance type?________% On insulin pump for private insurance patients ________% On insulin pump for Medicaid patients VALIDATE: 0 ≤ C33x ≤ 100. ELSE DISPLAY: “C33x: Please enter a numeric value between 0 and 100.”What percentage of your primary diabetes care (Type 1 and Type 2) patients (see C29.2a and C29.2b) aged 13 to < 18 years of age were screened for depression using a validated depression screening tool (such as the Beck Depression Inventory-II, PHQ-9, CDI) in the last calendar year? ________% Screened for depression NA. Did not see Type 1 or Type 2 diabetes patients aged 13-17 in the last calendar year. VALIDATE: 0 ≤ C34 ≤ 100. ELSE DISPLAY: “C34: Please enter a numeric value between 0 and 100.”C34.1What percentage of your primary diabetes care (Type 1 and Type 2) patients (see C29.2a and C29.2b) who had an abnormal score on their depression screen (see C34) were either referred for assessment by a mental health professional (social worker, licensed counselor, psychologist, or psychiatrist) or are already under the care of a mental health professional?________% Referred for assessment or under treatment for depression NA. Did not screen Type 1 or Type 2 diabetes patients for depression in the last calendar year.VALIDATE: 0 ≤ C34.1 ≤ 100. ELSE DISPLAY: “C34.1: Please enter a numeric value between 0 and 100.”This question has been removed from the survey.C35.1 Of the unique pediatric Type 1 diabetes outpatients (see C29.2a) < 18 years of age, what was the volume of patients seen by your Pediatric Diabetes program by each age group listed below and the number of patients achieving optimal Hemoglobin A1c control (defined as having at least one Hemoglobin A1c at or below 7.5% in the last calendar year). Please report the values separately for patients covered by private/commercial insurance versus Medicaid only for each of the defined age groups. [When submitting your survey, each hospital will be required to create and upload a deidentified table of patient data from your EMR or other records that shows the values for each requested element. For this question, the file should include a single row for each patient with a record identifier, the date of test value (which can be month or quarter if needed), the age, insurance type, and lowest A1c value for the last calendar year. In the spreadsheet, please also show your work for the calculations for patient volume and patients achieving optimal control. This information will be used to check your responses to this question.]When identifying data for your response to this question, please:Use the Type I outpatient data pulled in C29.2a;Calculate age as date of last visit minus date of birth;Flag each age category (0-5, 6-12, 13-17);Merge/join Type 1 outpatient data with A1c value data; Flag A1c values less than or equal to 7.5%; andDocument all of the above data in a spreadsheet as directed in the instructions for this question to be submitted with your survey.Volume of Treated PatientsUnique Type 1 Patients on Private Insurance treatedUnique Type 1 Patients on Medicaid Insurance treateda. 0-5 years old________________b. 6-12 years old________________c. 13-17 years old________________Patients Achieving Optimal ControlUnique Type 1 Patients on Private Insurance who achieve optimal A1c controlUnique Type 1 Patients on Medicaid Insurance who achieve optimal A1c controla. 0-5 years old________________b. 6-12 years old________________c. 13-17 years old________________C35.2Please identify all of the data sources that you consulted as you answered question C35.1. Check all that apply.Manual paper chart review Manual electronic medical record review Data extract (such as spreadsheet/ report) of electronic medical record Data extract of billing records Some “other” source C35.3If “Some ‘other’ source” selected in C35.2, please describe what “other” source was used in your response:For what percentage of unique pediatric Type 1 diabetes outpatients (see C29.2a) < 18 years of age were daily blood glucose measurements for the past 2 weeks reviewed (either from the patient’s manual log, meter/pump download, or internet based upload) at their last visit?________ % VALIDATE: 0 ≤ C36 ≤ 100. ELSE DISPLAY: “C36: Please enter a numeric value between 0 and 100.”Does your diabetes program have a written curriculum for diabetes self-management education (DSME) that explicitly addresses all Seven Self-Care Behaviors: Healthy Eating, Being Active, Monitoring, Taking Medication, Problem Solving, Reducing Risks, and Healthy Coping?YesNoDoes your pediatric Diabetes Program track the number of school days that are missed for diabetes-related reasons (hypoglycemia, hyperglycemia and/or DKA) by children and adolescents that go to school?YesNoThis question has been removed from the survey.Does your Pediatric Diabetes program have a dedicated team of type 2 diabetes providers (e.g., endocrinologists, dietitian, social worker and/or psychologist, exercise physiologist or equivalent) that see patients with type 2 diabetes?YesNoSKIP LOGIC: IF C29.2a1 + C29.2a2 + C29.2b1 + C29.2b2 > 0, ASK C41 – C43. ELSE, GO TO C44.This question has been removed from the survey.C41.1How many primary diabetes care (Type 1 and type 2) patients (see C29.2a and C29.2b) who are 10 to < 18 years of age had an LDL cholesterol value measured in the last 5 calendar years?? Of those, how many had an LDL cholesterol less than 130 at the most recent measurement? Please report the values separately for patients covered by private/commercial insurance versus Medicaid only. [If none, please enter 0.]Private InsuranceMedicaid Insurancea. Number of patients with LDL measurement________________b. Number of patients with LDL < 130________________VALIDATE: IF C41.1x IS NOT A WHOLE NUMBER, DISPLAY: “C41.1x: Please enter a whole number (no decimals).” IF C41.1b1 > C41.1a1, DISPLAY: “(Private Insurance) Number of patients with LDL <130 (C41.1b) cannot be greater than number of patients with any LDL measurement (C41.1a).”IF C41.1b2 > C41.1a2, DISPLAY: “(Medicaid Insurance) Number of patients with LDL <130 (C41.1b) cannot be greater than number of patients with any LDL measurement (C41.1a).”IF (C41.1a1 > SUM (C29.2a1, C29.2b1): “Please check your responses. You reported more patients 10 years of age with LDL measurements than primary diabetes care patients with private insurance reported in C29.2. Please correct your response on this screen or use the navigation menu on the left to return to C29.2.”IF (C41.1a2 > SUM (C29.2a2, C29.2b2): “Please check your responses. You reported more patients 10 years of age with LDL measurements than primary diabetes care patients with Medicaid insurance reported in C29.2. Please correct your response on this screen or use the navigation menu on the left to return to C29.2.”Does your hospital track seasonal influenza vaccination of primary diabetes care pediatric outpatients (see C29.2a and C29.2b) < 18 years of age who are currently in the care of your Pediatric Diabetes program?Yes No – Skip to Question C44Of the total vaccine eligible primary diabetes care pediatric outpatients (see C29.2a and C29.2b) < 18 years of age that were seen by your Pediatric Diabetes program between October 1, 2019 and December 31, 2019, what percentage are documented to have received seasonal influenza vaccine (at your hospital or elsewhere) during that time period or earlier that season?________% VALIDATE: IF C42=Yes AND C43=BLANK, DISPLAY: “C43: Please provide a value or answer No to C42.”0 ≤ C43 ≤ 100. ELSE DISPLAY: “C43: Please enter a numeric value between 0 and 100.”For patients with the following conditions, does your Pediatric Endocrinology program distribute (either as a handout or within the written visit summary given after the clinic visit) patient education materials that address the details of their condition?YesNoa.Adrenal Insufficiency○○b.Congenital Hypothyroidism ○○c.Diabetes Insipidus ○○For patients on the following medications, does your pediatric Endocrinology program distribute (either as a handout or within the written visit summary given after the clinic visit) patient education materials that address the potential side effects of taking the medications? YesNoAnti-thyroid Medication ○○Growth Hormone ○○Cortisol replacement ○○Oral contraceptive pills (OCPs) ○○Does your hospital have the following multidisciplinary treatment programs on site at your hospital that manage the care of patients with the following conditions? If yes, do pediatric endocrinologists regularly attend the programs (i.e., at least monthly)?Yes, and Pediatric Endo regularly attendsYes, but Pediatric Endo does NOT regularly attendNo programa.Lipid disorders ○○○b.Hypertension ○○○prehensive weight management ○○○d.Turner syndrome ○○○e.Cystic fibrosis-related diabetes ○○○f.Gender Dysphoria ○○○g.Disorders of Sexual Development ○○○h.Thyroid nodules ○○○i.22q11.2 Deletion Syndrome ○○○j.Muscular Dystrophy ○○○k.Prader Willi Syndrome ○○○Please indicate the number of unique pediatric patients seen in your Pediatric Endocrinology program as an outpatient in the last calendar year with the following diagnoses. [If none, please enter 0.]Unique Patientsa.Congenital adrenal hyperplasia (see code list) ________S and Endocrine tumors (See code list) ________c.Diabetes insipidus (see code list) ________d.Hypopituitarism including Panhypopituitarism, Growth Hormone Deficiency, TSH deficiency, ACTH deficiency, Gonadotropin Deficiency (see code list) ________e.Turner Syndrome (see code list)________f.Noonan Syndrome (see code list) ________g.Gender Dysphoria (see code list) ________h.Disorders of Sexual Development (see code list) ________i.Bone Disease (including metabolic and genetic conditions) (see code list)________j.Non-diabetes related hypoglycemia (see code list) ________k.Poly Cystic Ovarian Syndrome (see code list) ________VALIDATE:IF C47x IS NOT A WHOLE NUMBER, DISPLAY: “C47x: Please enter a whole number (no decimals).”How many newly diagnosed patients with growth hormone deficiency or with multiple pituitary hormone deficiencies (see code list) that include growth hormone deficiency were seen by your Pediatric Endocrinology program in the last calendar year? [If none, please enter 0.]________ Unique Patients VALIDATE: IF C48 IS NOT A WHOLE NUMBER, DISPLAY: “C48: Please enter a whole number (no decimals).”SKIP LOGIC: IF C48>0, ASK C49; ELSE SKIP TO C51.Of this group of newly diagnosed patients (identified in C48), how many received the following diagnostic or treatment measures? [If none, please enter 0.]Unique Patientsa.A brain or pituitary MRI in the last 2 calendar years (see code list) ________b.Growth hormone therapy in the last calendar year (see code list) ________c.Serum IGF-1 measurement in the last calendar year (see code list) ________VALIDATE: IF C49 IS NOT A WHOLE NUMBER, DISPLAY: “C49: Please enter a whole number (no decimals).”IF C49x > C48, DISPLAY: “The number of patients in C49x cannot be greater than the number of patients in C48.” Question removed from the Survey Does your Pediatric Endocrinology program provide the following diagnostic/treatment options on site at your hospital? If so, for items a-e how many unique patients received the procedure as ordered by the Pediatric Endocrinology program in the last calendar year? [If none, please enter 0.]YesNoUnique Patientsa.Diagnostic radioisotope scan (see code list)○○________b.Therapeutic radioiodine treatment for Graves disease (see code list – must have both diagnosis and procedure code) ○○________c.Therapeutic radioiodine treatment for thyroid cancer (see code list – must have both diagnosis and procedure code) ○○________d.Ultrasound guided fine needle biopsy or aspiration of a thyroid nodule (see code list – must have both diagnosis and procedure code)○○________e.Thyroidectomy (see code list)○○________f.Intraoperative PTH assay (see code list)○○g.Intravenous bisphosphonate therapy (see code list)○○WARNING: IF C51x1= “Yes” AND C51 x 2 = (0 OR BLANK), DISPLAY: “C51x: Please check your responses. You marked that you offer these treatment options, but reported no patients.”VALIDATE: IF C51x IS NOT A WHOLE NUMBER, DISPLAY: “C51x: Please enter a whole number (no decimals).” C51.1In the last calendar year, how many unique patients at your hospital received the following surgeries and were then admitted to the pediatric (not adult) inpatient service following surgery? [If none, please enter 0.]Unique Patientsa.Thyroid cancer surgery (See code list – must have both diagnosis and procedure code) ________b.Parathyroid surgery (See code list) ________c.Brain tumor surgery involving hypothalamus or pituitary (See code list)________d.Abdominal endocrine surgery (adrenal tumor including pheochromocytoma, paraganglioma, or pancreatectomy) (See code list)________VALIDATE: IF C51.1x IS NOT A WHOLE NUMBER, DISPLAY: “C51.1x: Please enter a whole number (no decimals).” This question has been removed.During 2019, did your Pediatric Endocrinology program engage in any of the following activities?YesNoa.Developed and implemented a written plan for program review and quality improvement for the Pediatric Endocrinology program ○○b.Determined appropriate data-based performance metrics for clinical quality in Pediatric Endocrinology ○○c.Track patient data (e.g., diagnoses, treatment plans, test results, emergency department visits, outpatient visits, current treatment regimens) and other supporting information to measure progress against your clinical quality improvement/performance metrics that are reported to management/leadership in Pediatric Endocrinology at least quarterly for all key metrics ○○d.Management/leadership in Pediatric Endocrinology presents results of your program’s clinical quality improvement/performance metrics to your clinical staff at least quarterly ○○e.Engaged in one or more clinical quality improvement/performance initiatives focused on improving a specific outcome in Pediatric Endocrinology ○○f.Reported quality improvement/performance metrics to hospital leadership (e.g., CMO, Department Chair, Committee of the Board of Trustees) at least quarterly ○○C53.1. If “yes” to C53e, please describe one outcome that you were evaluating and what actions your hospital has taken in the last year to improve care as a result of this clinical quality improvement/performance initiative. [To receive credit, you must discuss what actions your hospital took as a result of this quality initiative and the impact it had on your program.]:Does your Pediatric Endocrinology program have a clinical endocrinology database (for non-diabetes patients) that is used by the program to evaluate quality performance?YesNoC54.1.If “yes” to C54, please describe what patient metrics you follow in the database. To receive credit, you must identify what you measure and how this information is used by your program:Are endocrinology providers (physicians or APNs) physically on site and available during endocrine testing and infusion studies (e.g., growth hormone, adrenocorticotropic hormone [ACTH], or gonadotropin-releasing hormone [GnRH] analog stimulation testing) such that they could respond within 5 minutes in cases of an adverse event during testing? YesNoDoes your Pediatric Endocrinology program discuss all pediatric thyroid cancer patient cases in active treatment at a multidisciplinary tumor board attended by a Pediatric Endocrinologist with Pathology, Surgery, and Radiology also present?YesNoPlease indicate the number of unique patients in each of the following categories seen in your Pediatric Endocrinology program in the last calendar year. For each category, please also indicate the total number of outpatient visits or inpatient admissions with these patients in the last calendar year. [Note that your numbers may include all pediatric patients seen for care that are < 21 years of age. If none, please enter 0.]Unique PatientsVisits/ Admissionsa. Pediatric endocrinology outpatients excluding diabetes (see code list for exclusions) seen in the last calendar year ________________b. Pediatric endocrinology inpatients excluding diabetes (see code list for exclusions) seen in the last calendar year________________VALIDATE: IF C57x IS NOT A WHOLE NUMBER, DISPLAY: “C57x: Please enter a whole number (no decimals).” For all admissions to your hospital in the last year with a potentially severe endocrine disorder (including adrenal insufficiency, panhypopituitarism, diabetes insipidus: see code list), what percentage have an admission or consultation note written by a physician in your Pediatric Endocrinology program?75-100%50-74%25-49% < 25%Of the new congenital hypothyroidism patients (see code list) seen in your Pediatric Endocrinology program in the last calendar year, how many were in each of the following categories? [If none, please enter 0.]New Patientsa. Had a confirmatory serum TSH >50 uIU/ml and were referred at < 21 days of age? ________b. Of the patients identified in C59a, how many began thyroid hormone therapy on or before 21 days of age? ________VALIDATE: IF C59x IS NOT A WHOLE NUMBER, DISPLAY: “C59x: Please enter a whole number (no decimals).” IF C59b > C59a, DISPLAY: “Patients in C59b cannot be greater than patients in C59a.”C59.1How many unique congenital hypothyroidism patients (see code list), < 3 years of age at the time of their visit, were seen in your Pediatric Endocrinology outpatient clinic at least twice in the past calendar year? Of those, how many have at least 2 TSH values that fall within the normal range for that TSH assay?________ Unique Patients with congenital hypothyroidism________ Unique Patients with at least 2 TSH values in normal range VALIDATE: IF C59.1x IS NOT A WHOLE NUMBER, DISPLAY: “C59.1x: Please enter a whole number (no decimals).” IF C59.1b > C59.1a, DISPLAY: “Number of Patients with at least 2 TSH values in normal range cannot be greater than number of patients with congenital hypothyroidism.”Does your Pediatric Endocrinology program take a leadership role in organizing or supporting family support groups for special populations other than diabetes? (e.g., Turner syndrome, DSD, 22q11, transgender)?YesNoDoes your Pediatric Endocrinology program have a Family Advisory Board that includes families of non-diabetes Endocrinology patients?YesNoThis question has been removed from the survey.Does your Pediatric Endocrinology Program have a system in place to alert providers that the following types of patients have not returned for care (exam and/or laboratory tests) after an agreed upon time interval since their last visit?YesNoa.Type 1 diabetes ○○b.Congenital hypothyroidism ○○c.Congenital adrenal hyperplasia ○○d.Growth hormone therapy ○○e.Precocious puberty on therapy ○○f.Hyperthyroidism on anti-thyroid medication ○○Did your Pediatric Endocrinology program participate in multidisciplinary evaluation and management of the following types of patients in the past year?YesNoa.Endocrine complications in Hematology/Oncology patients ○○b.Endocrine complication in post-transplant patients○○c.Metabolic bone disease and/or osteogenic imperfecta, including ordering bisphosphonate infusions ○○d.Inborn errors of metabolism and/or evaluation of hypoglycemia ○○How many of the following types of conferences or educational programs did your Pediatric Endocrinology program host or conduct in the last calendar year? [If none, please enter 0.]Number of Conferencesa. Joint case conferences with your institution’s Internal Medicine Endocrinology program ________b. Joint case conferences with your institution’s Genetics program ________c. Pediatric Endocrinology case conference ________d. Pediatric Endocrinology journal club ________e. CME-granting educational activity or conferences________VALIDATE: IF C65x IS NOT A WHOLE NUMBER, DISPLAY: “C65x: Please enter a whole number (no decimals).” Describe a way that your hospital supported development of a physician-led innovation to improve health care delivery for Pediatric Endocrinology patients, and the impact it has had on the quality of care in the past year:Please list the number of IRB-approved clinical research studies or trials, in which a clinician from your program was PI or Co-PI, that give patients access to novel, unlabeled medications, or diagnostic/monitoring devices or treatments options. [If none, please enter 0.]________ Number of trials VALIDATE: IF C67 IS NOT A WHOLE NUMBER, DISPLAY: “C67: Please enter a whole number (no decimals).” For each study counted above, please list the NCT number for each trial. If no NCT available, please provide an explanation:CHIEF OF SERVICE APPROVALTo have this section of the survey accepted for scoring, the Service Chief for your Pediatric Endocrinology program must acknowledge that they have reviewed all responses and approve of the submission. To do this you will need to download, complete, and upload the approval form by the date of the final survey submission. Has the approval form for your Pediatric Endocrinology program been completed and uploaded to the Pediatric Hospital Survey website?Yes, the form as been submittedNo, the form has not been submitted. Please complete and upload the form before MENTS FOR SECTION C:If needed, you may provide clarifications to the responses you provided to the questions asked in this section only. All other comments, suggestions or questions should be sent to PediatricHospSurvey@. ................
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