Related Experiment Video
Updated: Dec 31, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Taking the Pain out of Somatization: Development and Implementation of a Hospital-Based Clinical Practice Guideline
Kristin A Kullgren1, Alanna Shefler2, Nasuh Malas3,4
1Pediatrics, kullgren@med.umich.edu.
Insights
Somatic symptom and related disorders (SSRDs) are often missed in hospitalized children. This study developed a standardized protocol to improve recognition and management of pediatric SSRDs in inpatient settings.
Area of Science:
- Pediatric Healthcare
- Psychiatry
- Clinical Practice Guidelines
Background:
- Somatic symptom and related disorders (SSRDs) are common but frequently underdiagnosed and poorly managed in pediatric inpatient settings.
- Limited literature addresses the specific challenges of SSRDs within this clinical environment.
- There is a need for standardized approaches to improve care for these patients.
Purpose of the Study:
- To characterize current practices for managing SSRDs in a tertiary care academic children's hospital.
- To identify workflow challenges and problem areas in the evaluation and management of pediatric SSRDs.
- To develop and implement a standardized protocol and clinical practice guideline for inpatient pediatric SSRD care.
Main Methods:
- A multidisciplinary team identified patients with SSRDs admitted between May 2012 and October 2014.
- Retrospective chart review was conducted on a convenience sample to assess population characteristics and current management.
- Lean methodology was employed to define current and future state practices, guiding intervention development.
Main Results:
- Thirty-six pediatric patients (ages 8-17) were included. Most presented with neurologic or pain complaints.
- The average length of stay was 5.44 days, with infrequent mental health consultations within 24 hours.
- Two-thirds of patients were not diagnosed with an SSRD, and a quarter had no mental health follow-up upon discharge.
Conclusions:
- A single-site institutional protocol, clinical practice guideline, and resources were developed for pediatric SSRD evaluation and management.
- This initiative provides a model for standardizing SSRD care in other inpatient pediatric settings.
- Improved recognition and management protocols are crucial for optimizing care for children with SSRDs.
Objectives:
The diagnostic category of somatic symptom and related disorders (SSRDs), although common, is often poorly recognized and suboptimally managed in inpatient pediatric care. Little literature exists to address SSRDs in the inpatient pediatric setting. The purpose of the study was to characterize current SSRD practice, identify problem areas in workflow, and develop a standardized approach to inpatient evaluation and management at a tertiary care academic children's hospital.
Methods:
A multidisciplinary group identified patients with SSRD admitted between May 2012 and October 2014. A retrospective chart review on a convenience sample was performed to identify population characteristics and current practice. Lean methodology was used to define current state practice and future state intervention. These methods were used to guide identification of problem areas, which informed protocol, a clinical practice guideline, and resource development.
Results:
Thirty-six patients aged 8 to 17 years met inclusion criteria for chart review. Most patients presented with either neurologic or pain-related complaints. The mean length of stay was 5.44 days (SD = 6.3), with few patients receiving a mental health consultation within 24 hours of hospitalization. Patients averaged 5.8 medical and/or psychiatric diagnoses on discharge (SD = 5.2), and two-thirds did not have an SSRD diagnosis. Half of patients had comorbid psychiatric diagnoses, whereas one-quarter were discharged with no mental health follow-up.
Conclusions:
In this study, we describe the process and content development of a single-site institutional protocol, clinical practice guideline, and resources for the evaluation and management of pediatric SSRDs. This study may serve as a model for similar standardization of SSRD care in other inpatient pediatric medical settings.
More Related Videos
06:15Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
15:18Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Related Concept Videos
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:27Diagnostic and Statistical Manual of Mental Disorders (DSM)
01:19Standards of Care II
01:24Treatment Strategies for Psychological Disorders
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
01:22Standards of Care I
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...