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"In a Constant State of Upheaval": Experiences Caring for Hospitalized Children in State Custody
Insights
Hospitalized children in state custody face unique challenges, including provider distress and resource limitations. Improving care requires better coordination and trauma-informed approaches for better outcomes.
Area of Science:
- Pediatric Healthcare
- Child Welfare Services
- Healthcare Provider Experience
Background:
- Children in state custody frequently require hospitalization, yet best practices for their care remain underexplored.
- This study investigates healthcare providers' perspectives on the needs of hospitalized children under state care.
Purpose of the Study:
- To explore healthcare providers' experiences and perceptions regarding hospitalized children in state custody.
- To identify key challenges and needs in caring for this vulnerable pediatric population.
Main Methods:
- Semi-structured interviews were conducted with 25 healthcare providers at an urban children's hospital.
- Interviews were audio-recorded, transcribed, and analyzed using inductive thematic coding.
Main Results:
- Providers reported stressors related to the Department of Children's Services and experienced emotional distress.
- Key themes included limited support resources, challenges in multidisciplinary care coordination, and patient-centered care considerations.
- Additional findings highlighted the complexity of medical and developmental needs, isolation, extended hospitalizations, and a perceived lack of control.
Conclusions:
- Healthcare providers face significant challenges when caring for hospitalized children in state custody.
- Enhancing outcomes necessitates prioritizing collaborative care coordination and implementing trauma-informed practices.
- Addressing identified stressors and improving support systems are crucial for optimizing care for these children.
Introduction:
Many children in state custody require concurrent hospitalization each year, but little is known about best practices in caring for them. This study explored healthcare providers' experiences working with and perceptions of the needs of hospitalized children in state custody.
Methods:
Twenty-five healthcare providers from an urban children's hospital completed semi-structured interviews that were audio-recorded, transcribed, and analyzed using an inductive, thematic coding approach.
Results:
Two sets of five themes emerged. First: (1) stressors associated with the Department of Children's Services, (2) emotional distress for providers, (3) limited support resources, (4) multidisciplinary care and coordination, and (5) patient-centered care. Second: (1) building relationships and forming attachments, (2) medical and developmental complexity, (3) isolation, (4) extended (sometimes medically unnecessary) hospitalization, and (5) lack of control.
Conclusions:
Participants identified the many challenges associated with hospitalization for this population. By prioritizing collaborative care coordination and trauma-informed practices, teams can enhance outcomes for these children.
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