Guiding Principles for Pediatric Hospital Medicine Programs

Mirkinson, Laura J.; Daru, Jennifer A.; Fisher, Erin; Garber, Matthew; Hain, Paul D.; Narang, A; Quiñonez, Ricardo; Rauch, Daniel A.; Aragona, Elena; Alexander, S. Niccole

doi:10.1542/peds.2013-2269

Cited by 28 publications

(5 citation statements)

References 10 publications

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“…It is clear that PHM has established itself as a field, with networks for research and quality improvement, more than 50 fellowship programs, divisions in prestigious departments of pediatrics and children's hospitals, devoted journals and textbooks, and a well-attended annual meeting. PHM has set standards for the core competencies in PHM, 11,12 for pediatric hospitalist programs, 22,23 for coordinating the hospital care of children, 24,25 for the curricular framework of fellowships, 26 and for the Entrustable Professional Activities expected of a hospitalist. 27 The vision for the future is that continued efforts in research, quality and systems improvement, and clinical care will, in fact, result in significant benefits for all hospitalized children.…”

Section: The Ongoing Evolution Of Pediatric Hospital Medicinementioning

confidence: 99%

The History of Pediatric Hospital Medicine in the United States, 1996‐2019

Roberts

Fisher

Rauch

2020

Journal of Hospital Medicine

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coined the term "hospitalist" and predicted an "emerging role in the American health care system." 1 Pediatrics was not far behind: In 1999, Dr Wachter joined Paul Bellet, MD, in authoring an article describing the movement within pediatrics. 2 An accompanying editorial, coauthored by a pediatric hospitalist and an office-based practitioner, attempted to answer which was "better" for a hospitalized child: A practitioner who knew the child and family or a hospitalist who might be more knowledgeable about the disease, its inpatient management, and how to get things done in the hospital? 3 The authors could not answer which model was better for an individual child with an invested primary pediatrician, but concluded that hospitalists have the potential to improve care for all children in the hospital-the future promise of Pediatric Hospital Medicine (PHM). This article traces the growth of PHM from 1996 to the present, highlighting developments that fueled the hospital movement in general and PHM in particular (Table).

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Section: The Ongoing Evolution Of Pediatric Hospital Medicinementioning

confidence: 99%

The History of Pediatric Hospital Medicine in the United States, 1996‐2019

Roberts

Fisher

Rauch

2020

Journal of Hospital Medicine

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“…A recent American Academy of Pediatrics statement recognizes “perioperative surgical and medical subspecialty care” as one of the guiding principles for a PHM program. 19 However, billing and payment for services is not yet straightforward for comanagement models, and are greatly influenced by local factors. Possibilities for payment for comanagement services include having the time of co-managing PHM providers being covered by institutions.…”

Section: Current Challenges and Issues For Surgical Comanagement In Tmentioning

confidence: 99%

“…Internal medicine trainees have reported training during residency of certain peri-operative conditions to be lacking. 28 While peri-operative care is an important aspect of hospitalist care, 19 it does not necessarily generalize to all areas of pediatrics. Thus, it is unclear how to train whom during residency to utilize time and effort maximally.…”

Section: Current Challenges and Issues For Surgical Comanagement In Tmentioning

confidence: 99%

Pediatric Hospital Medicine Role in the Comanagement of the Hospitalized Surgical Patient

Schaffzin

Simon

2014

Pediatric Clinics of North America

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synopsis Medical comanagement of surgical patients by pediatric hospital medicine providers has become increasingly common. Subjectively, the comanagement model is superior to more traditional consultative models because of the anticipatory preventive care and coordination hospitalists provide to patients and hospital colleagues. While some studies have demonstrated the value of the comanagement model in adults and children, others failed to do so. The coming years are both exciting and challenging for this emerging field as it attempts to sustain its early progress and define its future in pediatric hospital medicine.

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“…In contrast, in the United States, hospitalists mainly provide the care for these patients. Hospitalists are defined as “a physician whose primary professional focus is the general medical care of hospitalized patients and whose activities include patient care, teaching, research, and leadership related to hospital medicine” ( 22 ). Consequently, different needs and challenges for new residents becoming future pediatric subspecialists might prevail.…”

Section: Introductionmentioning

confidence: 99%

Targeted Training for Subspecialist Care in Children With Medical Complexity

et al. 2022

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BackgroundChildren with medical complexity (CMC) are prone to medical errors and longer hospital stays, while residents do not feel prepared to provide adequate medical care for this vulnerable population. No educational guidance for the training of future pediatric tertiary care specialists outside their field of expertise involving the multidisciplinary care of CMC exists. We investigated pediatric residents past educational needs and challenges to identify key learning content for future training involving care for CMC.MethodsThis was a prospective mixed-methods study at a single pediatric tertiary care center. Qualitative semi-structured interviews with residents were conducted, submitted to thematic content analysis, linked to the American Board of Pediatrics (ABP) general pediatrics content outline, and analyzed with importance performance analysis (IPA). Quantitative validation was focused on key themes of pediatric nephrology within the scope of an online survey among pediatric residents and specialists.ResultsA total of 16 interviews, median duration 69 min [interquartile range IQR 35], were conducted. The 280 listed themes of the ABP general pediatrics content outline were reduced to 165 themes, with 86% (theoretical) knowledge, 12% practical skills, and 2% soft skills. IPA identified 23 knowledge themes to be of high importance where improvement is necessary and deemed fruitful. Quantitative validation among 84 residents and specialists (response rate 55%) of key themes in nephrology yielded high agreement among specialists in pediatric nephrology but low interrater agreement among trainees and “trained” non-nephrologists. The occurrence of themes in the qualitative interviews and their calculated importance in the quantitative survey were highly correlated (tau = 0.57, p = 0.001). Two clusters of high importance for other pediatric specialties emerged together with a contextual cluster of frequent encounters in both in- and outpatient care.ConclusionRegarding patient safety, this study revealed the heterogeneous aspects and the importance of training future pediatric tertiary care specialists outside their field of expertise involving the multidisciplinary care of CMC. Our results may lay the groundwork for future detailed analysis and development of training boot camps that might be able to aid the improvement of patient safety by decreasing preventable harm by medical errors, especially for vulnerable patient groups, such as CMC in tertiary care pediatrics.

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Guiding Principles for Pediatric Hospital Medicine Programs

Cited by 28 publications

References 10 publications

The History of Pediatric Hospital Medicine in the United States, 1996‐2019

The History of Pediatric Hospital Medicine in the United States, 1996‐2019

Pediatric Hospital Medicine Role in the Comanagement of the Hospitalized Surgical Patient

Targeted Training for Subspecialist Care in Children With Medical Complexity

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