Clinical Report-Physicians' Roles in Coordinating Care of Hospitalized Children

PEDIATRICS (Impact Factor: 5.3). 10/2010; 126(4):829-32. DOI: 10.1542/peds.2010-1535
Source: PubMed

ABSTRACT The care of hospitalized children and adolescents has become increasingly complex and often involves multiple physicians beyond the traditional primary care pediatrician. Hospitalists, medical subspecialists, surgical specialists, and hospital attending physicians may all participate in the care of hospitalized children and youth. This report summarizes the responsibilities of the pediatrician and other involved physicians in ensuring that children receive coordinated and comprehensive medical care delivered within the context of their medical homes as inpatients, and that care is appropriately continued on an outpatient basis.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Effective communication between inpatient and outpatient providers may mitigate risks of adverse events associated with hospital discharge. However, there is an absence of pediatric literature defining effective discharge communication strategies at both freestanding children's hospitals and general hospitals. The objectives of this study were to assess associations between pediatric primary care providers' (PCPs) reported receipt of discharge communication and referral hospital type, and to describe PCPs' perspectives regarding effective discharge communication and areas for improvement.Methods We administered a questionnaire to PCPs referring to 16 pediatric hospital medicine programs nationally. Multivariable models were developed to assess associations between referral hospital type and receipt and completeness of discharge communication. Open-ended questions asked respondents to describe effective strategies and areas requiring improvement regarding discharge communication. Conventional qualitative content analysis was performed to identify emergent themes.ResultsResponses were received from 201 PCPs, for a response rate of 63%. Although there were no differences between referral hospital type and PCP-reported receipt of discharge communication (relative risk 1.61, 95% confidence interval 0.97–2.67), PCPs referring to general hospitals more frequently reported completeness of discharge communication relative to those referring to freestanding children's hospitals (relative risk 1.78, 95% confidence interval 1.26–2.51). Analysis of free text responses yielded 4 major themes: 1) structured discharge communication, 2) direct personal communication, 3) reliability and timeliness of communication, and 4) communication for effective postdischarge care.Conclusions This study highlights potential differences in the experiences of PCPs referring to general hospitals and freestanding children's hospitals, and presents valuable contextual data for future quality improvement initiatives.
    Academic Pediatrics 11/2014; DOI:10.1016/j.acap.2014.07.004 · 2.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Family-centered rounds (FCR) involve multidisciplinary rounds at the patient bedside with an emphasis on physicians partnering with patients and families in the clinical decision-making for the patient. Although the purpose of FCR is to provide patient-centered care, an unanticipated benefit of FCR may be to improve time to discharge. The objective of this study was to determine the impact of FCR on time to discharge for pediatric patients in an academic medical center.
    07/2014; 4(4):228-32. DOI:10.1542/hpeds.2013-0085
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care. Copyright © 2015 by the American Academy of Pediatrics.
    Pediatrics 01/2015; 135(1):e255-72. DOI:10.1542/peds.2014-3424 · 5.30 Impact Factor