Improving Emergency Care for Children With Medical Complexity: A Pragmatic Review

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Management
• Complex Care Coordination

Background:

• Children with medical complexity (CMC) represent a small but high-need pediatric population.
• CMC account for a disproportionate share of pediatric emergency department (ED) visits and healthcare costs.
• Providing high-quality emergency care for CMC presents unique challenges, including communication barriers and data access limitations.

Purpose of the Study:

• To review current strategies for reducing emergency care utilization by CMC.
• To explore methods for enhancing the quality of emergency care delivered to CMC.
• To identify future directions for improving care models for this vulnerable population.

Main Methods:

• Review of recent insights and successful strategies in ambulatory and emergency care for CMC.
• Analysis of outpatient programs aimed at reducing ED visits.
• Examination of in-ED care improvement initiatives, including emergency care plans.

Main Results:

• Targeted ambulatory care programs, such as next-day appointments and 24/7 provider access, can reduce ED visits.
• Emergency care plans improve access to critical health information for ED providers.
• Leveraging technology like EHRs and AI holds promise for managing emergency care plans.

Conclusions:

• Collaborative care models are essential to prevent acute exacerbations in CMC.
• Innovative approaches are needed to ensure high-quality emergency care for medically and socially vulnerable CMC.
• Future efforts should focus on integrated care and technological advancements to support CMC.