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Medically stable children in PICU: better at home
1Birmingham Children's Hospital NHS Foundation Trust.
Insights
Medically stable children with complex care needs, especially those needing long-term ventilation, face prolonged hospital stays due to delayed discharge packages. This impacts bed availability and well-being, necessitating improved UK-wide service commissioning and investment.
Area of Science:
- Pediatrics
- Healthcare Management
- Health Policy
Background:
- Medically stable children with complex care needs, including those requiring long-term ventilation, experience prolonged stays in acute hospital settings.
- Delayed discharge is often due to the complex process of formulating appropriate care packages.
- These extended hospitalizations negatively affect bed availability, particularly intensive care unit (ICU) beds, and can be detrimental to the well-being of children and their families.
Purpose of the Study:
- To highlight the issue of prolonged hospital stays for children with complex care needs awaiting discharge.
- To advocate for the establishment of realistic standards for timely discharge of medically fit children.
- To identify necessary improvements in service provision and policy for this vulnerable population.
Main Methods:
- This study is a policy analysis and review of current discharge practices for children with complex care needs.
- It examines the challenges associated with multi-agency working, planning, and commissioning of long-term care packages.
- The analysis draws on the understanding of healthcare system pressures and patient well-being.
Main Results:
- Children with complex care needs, particularly those on long-term ventilation, are experiencing inappropriate delays in hospital discharge.
- The current system lacks coordinated multi-agency planning and commissioning for essential long-term community care packages.
- The hospital environment poses risks to the well-being of children and their families.
Conclusions:
- Urgent need for UK governments to establish realistic standards for timely discharge of medically fit children with complex care needs.
- Requires increased investment in community children's nursing and transitional care units.
- A UK-wide framework for commissioning services is essential, alongside improved data collection, to ensure effective long-term support.
Abstract:
A number of medically stable children and young people with complex care needs, and in particular those requiring long-term ventilation, are spending inappropriately long periods of time in acute hospital settings waiting for discharge packages to be formulated. Apart from the impact this has on availability of inpatient beds for other children, specifically intensive care beds, the hospital environment can be detrimental to the well being of the child/young person and family. Discharging these children home requires complex multi-agency care packages to be established, with a high degree of co-ordinated multi-agency working, planning and commissioning that must be continued in the long term. UK governments need to set realistic standards for timely discharge of children with complex care needs once they are deemed medically fit. To achieve these standards there needs to be additional investment in community children's nursing and transitional care units, improved data collection and a UK-wide framework for commissioning of services for children and families with complex care needs.
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