Consensus Statement on Urgent Care Centers and Retail Clinics in Acute Care of Children

Abstract

This article provides recommendations for pediatric readiness, scope of services, competencies, staffing, emergency preparedness, and transfer of care coordination for urgent care centers (UCCs) and retail clinics that provide pediatric care. It also provides general recommendations for the use of telemedicine in these establishments. With continuing increases in wait times and overcrowding in the nation's emergency departments and the mounting challenges in obtaining timely access to primary care providers, a new trend is gaining momentum for the treatment of minor illness and injuries in the form of UCCs and retail clinics. As pediatric visits to these establishments increase, considerations should be made for the type of injury or illnesses that can be safely treated, the required level training and credentials of personnel needed, the proper equipment and resources to specifically care for children, and procedures for safe transfer to a higher level of care, when needed. When used appropriately, UCCs and retail clinics can be valuable and convenient patient care resources.

Pediatric Urgent Care Center Management of Traumatic Injuries in Infants and Children

“…This equipment and these medications reduce morbidity and mortality in cases of significant head/neck injuries, hemorrhagic shock associated with trauma, and persistent blood loss, respectively. Although both the American Academy of Pediatrics and the American College of Emergency Physicians have suggested that urgent cares have certain equipment and medications available for both medical and traumatic emergencies, there are no national guidelines specific to PUCs 1,2 …”

“…Although both the American Academy of Pediatrics and the American College of Emergency Physicians have suggested that urgent cares have certain equipment and medications available for both medical and traumatic emergencies, there are no national guidelines specific to PUCs. 1,2 Similarly, there are a lack of PUC-specific evidence-based guidelines for the management of trauma. Pediatric urgent cares often rely on guidelines meant to apply to the ED setting, such as those from the Pediatric Emergency Care Applied Research Network.…”

“…Life threatening emergencies that require immediate recognition, stabilization, and transfer may present to UCCs. Both the American Academy of Pediatrics Committee on Pediatric Emergency Medicine and the American College of Emergency Physicians Emergency Medicine Committee have suggested that UCC providers be able to provide timely assessment, initial resuscitation, and stabilization of critically ill or injured children and be able to initiate transfer of pediatric patients requiring a higher level of care, including children with medical, traumatic, and behavioral health or mental health emergencies 1,2 . As of 2018, there were approximately 9000 general UCCs in the United States and an estimated 320 pediatric urgent care (PUC) centers 3,4 .…”

“…Both the American Academy of Pediatrics Committee on Pediatric Emergency Medicine and the American College of Emergency Physicians Emergency Medicine Committee have suggested that UCC providers be able to provide timely assessment, initial resuscitation, and stabilization of critically ill or injured children and be able to initiate transfer of pediatric patients requiring a higher level of care, including children with medical, traumatic, and behavioral health or mental health emergencies. 1,2 As of 2018, there were approximately 9000 general UCCs in the United States and an estimated 320 pediatric urgent care (PUC) centers. 3,4 Accompanying the increase in PUCs, the Society for Pediatric Urgent Care was formed to support PUCs by sharing information about practice management, strategic planning, and clinician education.…”

9-1-1 Activations from Ambulatory Care Centers: A Sicker Pediatric Population

“…1,2 Currently, UC outnumbers emergency departments (EDs) and the industry is expected to expand further. [2][3][4] They are designed to provide acute care for minor illness and injury and neither UC or physician-based office practices (henceforth termed ambulatory care practices [ACPs]) are equipped to treat more emergent major illness or injury. 2 There are limited data on the number of emergencies at such facilities; quite dated work suggested a relatively high rate of out-patient visits requiring urgent treatment, on the order of one child per week per clinician.…”