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Aging the Pediatric Patient

Please review this file download and observe how patient age is calculated, and how cohorts are created for each category of Pediatric Patient. Please go thru each of the worksheets presented as “Step 1”, “Step 2”, and so forth. Upon completion, create a Pivot Table in Step 6 which analyzes the Pediatric patient data by age cohort in Step 5. Submit the MS Excel file here.

Part 2: Case StudyWeek 2:Defining Age Cohort Definitional Problems in anAcute Care Hospital Quality Resource DepartmentCase Background: A 450 bed acute care hospital that was runningat a typical daily occupancy of rate of 86% performs approximately 85focused chart reviews per day, concentrating on a number of factors, including the patient’s length of stay (LOS), severity, current diagnosis, pre-operative surgical risk factor status, infection status, current medication protocols, and a number of behavioral health indicators.During the course of developing chart review protocolsin anticipation of a focused review involving the Department of Pediatrics, a lively discussion ensued among the Quality Resource Management (QRM) staff as to what constituteda “Pediatric”case. A number of members of the team had different opinions as to which patient ageboundaries should be used whendesignating a case to qualify as “Pediatric”. Some members felt that many of the older patients seen within the Pediatric Department should be classified as “adults”due to a number of physiological and psychological factors, while other members of the team felt that it was important, for reasons of data consistency, to maintain the traditional pediatric age cut-off point of “under age 18years”for designating pediatric patients.Data Collection, Preparation, and Analysis: The Chairman of the Department of Pediatrics charged those individuals responsible for data collection, preparation, and analysis to take an “open”and “flexible”approach to the issue of designating which patients would be considered “pediatric”from a clinical perspective versus from an administrative perspective. In essence, the Chairman was directing the team to analyze the datain such a way that would permit grouping of patients by age into multiple cohorts. One member of the team cautioned that creating multiple definitions of “pediatric”might create confusion when conducting analysis. Conclusion: The Quality Resource Management staff ultimately decided to create sixage cohort designations based on the patient’s age at the time of admission. These cohorts consisted of these groupings:

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Pt Age RangePt Age Range Designation< 1 YearInfant1 –3YearsToddler4–10YearsPediatric11 –12YearsPreAdolescent13 –15 YearsAdolescent16 –17 YearsPost AdolescentUnanticipated Outcome:Shortly after this decision was made, the QRM staff discovered that a similar issue existed for patients classified as “Geriatric”. In this case, the discussion focused on the gradualincrease in patient age experienced in the healthcare environment, with specific attention to patients who are over the age of 90. In this case, the Quality Resource Management Team developed the following age cohorts to describe patients who previously had all been collapsed into a single category of “Geriatric”:Pt Age RangePt Age Range Designation65-69Young Geriatric70-74Septuagenarian 175-79Septuagenarian 280-84Octogenarian 185-89Octogenarian 290-99Nonagenarian100+Centenarian

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