Medically Complex Children; Defining A Specialty| Biomed Grid

Medically complex children can be defined as subset of pediatrics with multiple co-morbidities, technology dependence, increased healthcare needs, and significant functional limitations [1]. The proportion of medically complex children requiring services in the pediatric healthcare environment is rapidly increasing [1]. In addition, medically complex children have the potential to significantly impact institutional indicators of success including hospital-readmissions and mortality rates, as well as healthcare costs [2,3]. Significant vulnerability as well as increased reliance on artificial and technological devices for survival may also disproportionally impact other quality measures of success including nosocomial infections, ventilator associated pneumonia, central line associated blood stream infections, surgical site infections, catheter associated urinary tract infections, pressure ulcer rates, and sepsis morbidity and mortality rates. As a result, comprehensive and expert care from clinicians that can provide additional surveillance to mitigate complications and to promote optimal patient outcomes is necessary. However, the term “medically complex” alone may be ambiguous and may not provide clinicians nothing more than perhaps several assumptions. Unlike other clinical specialties within pediatrics and healthcare, the care of medically complex children can be difficult to define as a specialty. Without adequate training and preparation, this uniquely vulnerable population is at even greater risk. Therefore, it is imperative that clinical leaders caring for medically complex children advocate for this population by first recognizing it as unique from general pediatrics of well-children, with whom have a separate set of risks and complications and define as a specialty alongside other well-established pediatric populations. This clear delineation establishes a foundation for further education and preparation of clinicians providing care to medically complex children.