@Article{chd.12438,
AUTHOR = {Antonio R. Mott, Steven R. Neish, Melissa Challman, Timothy F. Feltes},
TITLE = {Defining pediatric inpatient cardiology care delivery models: A survey of pediatric cardiology programs in the USA and Canada},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {3},
PAGES = {294--300},
URL = {http://www.techscience.com/schd/v12n3/39113},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> The treatment of children with cardiac disease is one of the most prevalent and costly
pediatric inpatient conditions. The design of inpatient medical services for children admitted to and
discharged from noncritical cardiology care units, however, is undefined. North American Pediatric
Cardiology Programs were surveyed to define noncritical cardiac care unit models in current practice.<br/>
<b>Method:</b> An online survey that explored institutional and functional domains for noncritical cardiac
care unit was crafted. All questions were multi-choice with comment boxes for further explanation. The survey was distributed by email four times over a 5-month period.<br/>
<b>Results:</b> Most programs (n = 45, 60%) exist in free-standing children’s hospitals. Most programs
cohort cardiac patients on noncritical cardiac care units that are restricted to cardiac patients in 39
(54%) programs or restricted to cardiac and other subspecialty patients in 23 (32%) programs. The
most common frontline providers are categorical pediatric residents (n = 58, 81%) and nurse practitioners (n = 48, 67%). However, nurse practitioners are autonomous providers in only 21 (29%)
programs. Only 33% of programs use a postoperative fast-track protocol. When transitioning care
to referring physicians, most programs (n = 53, 72%) use facsimile to deliver pertinent patient
information. Twenty-two programs (31%) use email to transition care, and eighteen (25%) programs use verbal communication.<br/>
<b>Conclusion:</b> Most programs exist in free-standing children’s hospitals in which the noncritical cardiac care units are in some form restricted to cardiac patients. While nurse practitioners are used
on most noncritical cardiac care units, they rarely function as autonomous providers. The majority
of programs in this survey do not incorporate any postoperative fast-track protocols in their practice. Given the current era of focused handoffs within hospital systems, relatively few programs
utilize verbal handoffs to the referring pediatric cardiologist/pediatrician.},
DOI = {10.1111/chd.12438}
}