• Christian D Pulcini, Amy Dubuque, Miles Lamberson, Michelle L Macy, Rakesh D Mistry, Christopher M Pruitt, David Schnadower, Joseph J Zorc, and Martha W Stevens.
• From the Division of Emergency Medicine, Department of Surgery and Pediatrics.
• Pediatr Emerg Care. 2022 Aug 1; 38 (8): e1423e1427e1423-e1427.

ObjectiveChildren with medical complexity (CMC) compose 1% of the pediatric population but account for 20% of pediatric emergency department (ED) visits. Previous descriptions of challenges and interventions to ensure quality of care are limited. Our objective was to elicit pediatric emergency medicine (PEM) physicians' perspectives on challenges and opportunities for improvement of emergency care of CMC, with a focus on emergency information forms (EIFs).MethodsWe conducted a web-based survey of PEM physicians participating the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. The survey was designed using an expert panel, and subsequently piloted and revised to an 18-item survey. Data were analyzed with descriptive statistics.ResultsOne hundred fifty-one of 495 respondents (30%) completed the survey. Most respondents (62.9%) reported caring for >10 CMC per month. Whereas overall medical fragility and time constraints were major contributors to the challenges of caring for CMC in the ED, communication with known providers and shared care plans were identified as particularly helpful. Most respondents did not report routine use of EIFs. Anticipated emergencies/action plan was deemed the most important component of EIFs.ConclusionsMost PEM physicians view the care for CMC in the ED as challenging despite practicing in high-resource environments. Further research is needed to develop and implement strategies to improve care of CMC in the ED. Understanding experiences of providers in general ED settings is also an important next step given that 80% of CMC present for emergency care outside of major children's hospitals.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

29 keywords...

hide…