SPUC members:  We have planned a QI project for the 2025 calendar year.  This project will run from February through October 2025 and will grant ABP MOC part 4 credit. The purpose of this project is to decrease the unnecessary use of abdominal x-rays in patients with constipation or abdominal pain.  We need your involvement to make this project a “MULTICENTER” project.  When joining SPUC in this project, you will have support with data collection, data review, run chart development and QI learnings to help have successful PDSA cycles.

By decreasing unnecessary radiographs of patients with abdominal complaints we hope to facilitate the following:

1. Improve financial stewardship by decreasing costs associated with x-rays.
2. Improve patient safety by reducing unnecessary radiation exposure.
3. Improve efficiency of pediatric urgent care visits by decreasing time spent obtaining unneeded x-rays.

Here is our project timeline:

January 2025: Welcome online meeting

February-April 2025: 3 months of baseline data collection and first quarterly online educational session regarding QI topics.

May- October: 2 PDSA cycles with monthly data collection. 2 more quarterly online educational sessions along with monthly workgroup meetings.

November-December 2025: Project wrap up, submit and receive ABP MOC part 4 credit.

The project expectations are:

1. Watch the educational sessions either in real time or afterwards (these will be recorded)
2. Attend monthly work group meetings: February – October
3. Review 10 of your patients charts a month (February to October) and put anonymous data into redcap.
4. Help plan and implement 2 interventions at your local site.

If interested send an e-mail to [email protected] or [email protected] to get started.

Medscape has released the new CDC Expert Commentary  “5 things to know about AFM.”
Title: 5 Things to Know About Acute Flaccid Myelitis
Expert/Faculty: Janell A. Routh, MD, MHS
Posting Date: October 15, 2019
Link: medscape.com/viewarticle/919704?src=par_cdc_stm_mscpedt&faf=1

Also this month, a paper on AFM was published in Nature Medicine, with main authors from UCSF with CDC as collaborators.
Date: 10/21/19
Type: Journal Article
Title: Pan-viral Serology Implicates Enteroviruses in Acute Flaccid Myelitis
Publication: Nature Medicine
Authors: Schubert RD, Hawes I, Ramachandran PS, et al.

How you can help:
To increase awareness about AFM among healthcare professionals, we need your help to continue to spread the word about AFM:

• Consider forwarding this email to partners on your listserv
• Post a link to the commentary and the article on your website

CDC recently released an article in Pediatrics about acute flaccid myelitis activity in the United States from 2015 to 2017.

Key Findings

• From 2015 to 2017, 193 patients aged 21 and younger in 41 states were confirmed to have AFM.
• Most cases (116) occurred between August and November, with the largest number of cases (143) occurring in 2016.
• The median age of cases was 6 years.
• Strong evidence pointed to viruses, including enteroviruses, as having a role in these AFM cases.
• Most cases (79%) had a respiratory illness or fever less than a week before weakness onset.
• One CSF specimen tested positive for coxsackievirus A16; finding virus in the spinal fluid continues to be challenging.
• Close to 30% of respiratory specimens tested positive for enteroviruses or rhinoviruses.
• No single pathogen was identified as the primary cause of AFM

How You Can Help:
Variability in awareness about AFM can lead to underreporting to the health department and affect timely collection of appropriate specimens. Continue to spread the word about AFM by sharing this information with colleagues, posting links to the article, or by retweeting CDC’s AFM tweets from @DrNancyM_CDC and @CDCdirector.

March 28, 2019
The Centers for Disease Control and Prevention (CDC) has issued a health advisory, notifying clinicians that influenza activity remains high in the United States, with an increasing proportion of activity due to influenza A(H3N2) viruses, continued circulation of influenza A(H1N1) viruses, and low levels of influenza B viruses. Influenza should be considered as a possible diagnosis for patients with respiratory illness while local influenza activity remains elevated. CDC recommends antiviral medications for treatment of influenza, regardless of a patient’s influenza vaccination status.  Details here. 

The Society for Pediatric Urgent Care is pleased to announce the additional of two new board members.  Dr. Amy Romashko is a Pediatrics specialist at Children’s Hospital of Wisconsin. Dr. Romashko facilitates “Language of Caring” modules created to help improve communication between providers and families.  She is an active member of the SPUC Program committee.  Dr.  John Santos joins us from Children’s Hospital Colorado. Dr Santos has received numerous Patient-Family awards.  He is chair of the American Academy of Pediatrics (AAP) subcommittee on Urgent Care.