Caring for critically ill children in the community: a needs assessment

Area of Science:

• Pediatric Critical Care Medicine
• Healthcare Provider Education
• Community Hospital Management

Background:

• Critically ill children often initially present to community hospitals before transfer to specialized centers.
• Front-line healthcare providers in these settings require specific support for optimal management.
• Understanding barriers and facilitators is key to improving care coordination.

Purpose of the Study:

• Identify barriers and facilitators in managing critically ill children in community hospitals.
• Assess the needs of front-line healthcare providers in these settings.
• Inform strategies to support pediatric critical care prior to transfer.

Main Methods:

• Qualitative needs assessment conducted in five community hospitals.
• Focused interviews and focus groups with physicians, nurses, and respiratory therapists.
• Analysis of common themes related to managing critically ill pediatric patients.

Main Results:

• Most participants saw few critically ill children monthly; younger patients and respiratory conditions caused most anxiety.
• Staffing, equipment, and layout impacted care delivery.
• Real-world experience and expert support improved provider confidence; web-based guidelines were not utilized.

Conclusions:

• Community hospital providers need enhanced support for managing critically ill children.
• Focus on younger pediatric patients, technical skills, and managing resource limitations is necessary.
• Mentorship and expert engagement are vital, complementing, not replacing, passive guidelines.