The effects of the COVID-19 pandemic on risk management practice: A report from the epicenter of the epicenter in New York City.

Health care organizations have had to respond to the Coronavirus disease 2019 (COVID-19) pandemic in unprecedented ways. In the United States, where health risk management is an established profession, health care risk managers (HRMs) contributed to the response by supporting organizations and frontline workers. HRMs advised administrative and clinical leadership on decisions and policies aimed at addressing the medico legal, ethical, and operational dilemmas raised by this public health emergency. This article describes these challenges from the perspective of a New York City (NYC) public hospital located in the "epicenter within the epicenter" of the pandemic and aims to provide practical guidance for HRMs on the front lines of this crisis.

COVID-19: the effects on the practice of pediatric emergency medicine.

An informal survey of 65 pediatric emergency department leaders in North America-from 30 U.S. states and 4 Canadian provinces-revealed changes in operations, infrastructure, staffing, and clinical care that were undertaken as a result of the COVID-19 pandemic. The changes identified by the survey respondents were driven by reductions in pediatric patient volumes, a surge of adult patients, clinical considerations related to containment of infection, and financial factors. Survey respondents also reported effects of the pandemic on academic training programs and provider wellness. This report uses the survey responses to provide a snapshot of the adaptability of pediatric emergency medicine departments and clinicians during a public health emergency.

COVID-19: The impact on pediatric emergency care

Although there is still much that is not understood, experience with previous coronavirus outbreaks and available data on COVID-19 indicate a reduced propensity to affect children. Nonetheless, serious complications­although rare­are being seen in pediatric patients. This review, written with the emergency medicine clinician in mind, describes the epidemiology, clinical features, and management implications for COVID-19 in pediatric patients. It includes a discussion of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, as well as other aspects of the COVID-19 pandemic that are affecting children and families, such as poisonings, childhood immunizations, mental health, nonaccidental trauma, and neglect.

Trends and challenges in international pediatric emergency medicine.

PURPOSE OF REVIEW: Pediatric emergency care internationally is practiced in a wide variety of local contexts, and the quality of care varies. International pediatric emergency medicine refers to the spectrum of care provided to children with serious illnesses and injuries globally. This article serves as the first of its kind to characterize current trends and challenges in this area. RECENT FINDINGS: Current trends in international pediatric emergency medicine include international dissemination of pediatric emergency medicine guidelines, pediatric-specific disaster relief training, increasing numbers of pediatric emergency medicine research collaboratives, interest groups and training programs, and increasing numbers of spaces dedicated to pediatric emergency care. Current challenges to the field include inequalities in access to medical research and information, various nonmedical barriers and lack of reports describing approaches to the delivery of pediatric emergency care. SUMMARY: While there are many recent advances in the state of pediatric emergency medicine internationally, there still exist many barriers to the improvement in its quality. Many of these obstacles are not specific to pediatric emergency medicine, but reflect overall disparities between the developing and developed worlds. One first step to overcoming pediatric emergency medicine practiced in isolation is a formal organization of the field of international pediatric emergency medicine.

A Spanish version of the McGill Quality of Life Questionnaire.

Although Spanish is a major world language and increasingly common in North America, most instruments that measure quality of life (QOL) are written in English, limiting researchers' ability to assess QOL in patients who speak only Spanish. In this article, we present a Spanish version of the McGill Quality of Life Questionnaire (MQOL), a validated instrument found particularly relevant for patients with life-threatening illness. A translation/back-translation method, supplemented with review by a committee composed of lay persons and clinicians speaking Puerto Rican, Dominican, Mexican, Salvadoran, Ecuadorian, and Colombian Spanish, was used to achieve conceptual equivalence with the English version. Our initial review demonstrated face validity for the Spanish version of the MQOL. However, further testing is required to fully determine its psychometric properties and to provide a version that has been validated in use.