An Integrated Nurse Practitioner-Run Subspecialty Referral Program for Incontinent Children

Area of Science:

• Pediatric healthcare delivery
• Integrated care models
• Dysfunctional elimination syndrome

Background:

• Urinary and fecal incontinence often represent a single syndrome with varied manifestations.
• Current care for children with incontinence is fragmented across pediatric subspecialties.
• An integrated, multidisciplinary approach is needed to improve care for these children.

Purpose of the Study:

• To report the success of an innovative, integrated care program for children with incontinence and dysfunctional elimination.
• To evaluate the program's financial viability, patient satisfaction, and referral base.
• To highlight the potential of integrated, non-physician-led specialty practices.

Main Methods:

• Retrospective analysis of financial data, patient satisfaction scores, and referral patterns.
• Assessment of a novel program combining urology, gastroenterology, and psychiatry services.
• Evaluation of an independent nurse practitioner-run specialty referral practice.

Main Results:

• The integrated care model is fiscally sound.
• Patient satisfaction scores are comparable or higher than traditional physician-run clinics.
• The program has a broad geographic referral base without active marketing.

Conclusions:

• Integrated care models can effectively manage complex pediatric conditions like dysfunctional elimination.
• This model demonstrates the potential for nurse practitioners to lead specialty referral practices.
• The approach may be adaptable to other pediatric populations with fragmented care needs.