Continuous Publishing as Next Step in Continuous Improvement at Hospital Pediatrics

Abstract

We are excited to announce that Hospital Pediatrics has moved to a continuous publishing model. What is continuous publishing? It is a relatively new model in which articles are published shortly after acceptance versus the historical model of publication occurring when space was available in the next issue that went to press. This historical model guaranteed at least 2 to 3 months between acceptance and publication due to the time needed to generate the proofs, copyedit, respond to changes, and then generate and print the full issue. At times when the number and/or quality of submissions increased (as we have seen a lot of recently at Hospital Pediatrics), this 2- to 3-month delay could grow to 4 or 5 months, as the next issue or issues to go to press may already be full. This delay is bad for our author teams and bad for science, and it was based only on the needs of the print publishing industry. Hospital Pediatrics, like most other journals, has been taking advantage of the efficiencies of digital publishing and the internet for many years now, and this is just the latest step. We began rapid e-publishing of particularly impactful science some years ago, and this process became more common during the COVID-19 pandemic, with the goal of quickly sharing research findings with potentially outsized public health implications. As we complete the transition to continuous publishing over the next several months, we will see our acceptance to publication time decrease from 4 or 5 months to 1 to 3 weeks, ensuring authors will see their work published months faster and readers will see cutting-edge science more quickly. We will emphasize to our authors to continue to review and revise page proofs as efficiently as they are able, as it is now true that quicker review of proofs leads directly to earlier publication. Papers that are covered by public access policies will have the option of our Green Open Access, further showing our commitment to getting the best science released to the public as quickly as possible.Continuous publishing is the most recent step our team has taken to reduce delays and friction in the peer review process, but it complements work our leadership team has pursued over the last several years. We intentionally did not place review time/efficiency metrics in the forefront during our first decade as a journal. Under Dr Shawn Ralston’s leadership we aimed to grow—and succeeded in growing the field of pediatric hospital medicine (PHM)—intentionally and deliberately. We knew we were often seeing a first author’s first paper, something that just about never happens in the biggest journals in medicine, and we saw our editors’ and reviewers’ time as an investment in that author team. We frequently went through 3 to 5 rounds of revisions, but the science got better and clearer, and the author team, journal, and field benefited from that investment when the first submission of that team’s second paper came in stronger. One cannot hit the fast-forward button on 4 rounds of peer review.More recently, as the quality and quantity of our original science submissions continued to increase, our executive editorial board realized we needed to think a bit differently to best serve science and the field of PHM. Our long odyssey to receiving our impact factor finally ended in June 2025. We received an impressive debut number of 2.1, which told authors outside of North America and PHM something we think that most everyone in PHM already knew: Our field does amazing research, and Hospital Pediatrics published much of it using a thoughtful review process that leads to impactful and frequently cited science. And researchers outside of North America and PHM noticed, with our new submissions increasing over 60% last year, many from international author groups and other subspecialties. With these important benchmarks achieved, we turned our focus on other ways we could make the author experience better, with a focus on timeliness of peer review. We made the difficult decision that administrative rejection, also called rapid rejection, before peer review was a decision type we needed to use more often, with 2 important goals for the journal mission: (1) minimize time spent in peer review for papers we were very unlikely to accept; and (2) reduce the use of the very valuable time of our general editorial board and peer reviewer pool for original science we ultimately were not going to publish in Hospital Pediatrics. Our number of rapid rejection decisions more than doubled from 2024 to 2025, going from 106 to 236. We do try each time—and believe we have been successful—to add a brief, encouraging, personalized message as we note that even science we cannot accept represents dozens of brilliant people’s and teams’ hard work. We do see the journal as having a special responsibility to supporting early-stage authors, so we try particularly to provide formative and encouraging comments to trainees and junior faculty. Particularly at these early-career stages, successfully completing a study and writing it up is an amazing achievement, and one that authors should be proud of, even if it is increasingly the case that we cannot publish their work in Hospital Pediatrics.We also took steps as an executive editorial board to be more selective and strategic in how we use peer reviewers on R1 and R2 submissions. Moving to more frequent editor-only review at the revision stages speeds along the peer review process and prioritizes our reviewer pool’s focus on new submissions, where it is most significant for the journal. With these changes, we have seen our overall time in peer review reduced by over 25% over the last 3 years while continuously increasing the rigor and quality of the work we publish.We wanted to close with celebration and gratitude. We have an amazing team at the journal, and we would like to emphasize our tremendous thanks to Will Larkin, our Managing Editor, and Kate Larson, our Senior Managing Editor. Not a single journal issue would be published without their efforts; as such, none of our successes would be possible without them. We are also indebted to our Associate and Assistant Editors, General Editorial Board Members, and all of the reviewers and authors who have helped Hospital Pediatrics evolve from the newsletter that Jennifer Daru first envisioned to help connect our young field to a first-class scientific journal that leads science in a maturing academic field. We hope that these changes will help us to get to the next milestones, as a journal, and as a subspecialty. Thank you all!