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Related Experiment Video

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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
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Pediatric Chronic Critical Illness: Reducing Excess Hospitalizations.

Renee D Boss1,2, Erin P Williams2, Carrie M Henderson3,4

  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland; rboss1@jhmi.edu.

Hospital Pediatrics
|July 29, 2017
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Summary
This summary is machine-generated.

Children with chronic critical illness (CCI) experience prolonged hospitalizations due to fragmented care and insufficient support. Improving care coordination and home health services can reduce excess hospital days for these vulnerable pediatric patients.

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Area of Science:

  • Pediatric critical care medicine
  • Health services research
  • Family-centered care

Background:

  • The population of chronically critically ill (CCI) children requiring prolonged hospitalizations and technological support has grown over the past two decades.
  • Illness complexity contributes to frequent hospitalizations, but modifiable factors also play a role.

Purpose of the Study:

  • To explore patient, family, and health system factors contributing to excess hospital days for children with chronic critical illness (CCI).

Main Methods:

  • Semistructured interviews were conducted with 51 stakeholders (interdisciplinary providers and parents of children with CCI) across 5 metropolitan areas.
  • Qualitative analysis of interview transcripts identified key themes related to care challenges.

Main Results:

  • Stakeholders identified inadequate communication and coordination, gaps in pediatric home health services and durable medical equipment, inconsistent parent support, and restrictive policies as causes of prolonged hospitalizations.
  • Despite agreement that homelike settings are ideal, children with CCI experience extended hospital stays.

Conclusions:

  • An intentional care model is needed to minimize hospitalizations for the growing pediatric CCI population.
  • Hypotheses generated include the potential impact of expanded home nursing, robust care coordination, and enhanced family/clinician support to reduce hospital days.