Defining pediatric inpatient cardiology care delivery models: A survey of pediatric cardiology programs in the USA and Canada

Abstract

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.

Advanced fellowship training for cardiology fellows in acute care cardiology

“…There is significant variation in ACCU environments, such as staffing, resources, and care capabilities. 2,3 Categorical paediatric cardiology fellowship typically allows for observation of a single inpatient environment. In order to generalise care practices to other hospital systems, exposure to three different ACCU environments through an advanced ACC fellowship allows the trainee to consider appropriate application of different care models in their future practice.…”

Variation in care practices across pediatric acute care cardiology units: Results of the Pediatric Acute Care Cardiology Collaborative (PAC 3 ) hospital survey

“…In 2009, The Joint Commission’s National Patient Safety Goals included the improved identification and response to clinical deterioration of hospital‐ward patients . In 2016, a brief survey of North American pediatric cardiology programs was the first to describe the structure of inpatient, acute care services in noncritical cardiac care units . This study by Mott et al included 72 responding centers that answered a 25‐item questionnaire.…”

“…However, these efforts are often performed in isolation, resulting in widespread variation in models of CHD acute care. The variation among noncritical pediatric cardiac acute care units (CACUs) was previously described by Mott et al, who proposed creation of “uniform nomenclature to define the critical care elements needed for inpatient cardiology care.”…”

Family-centered care and acute care cardiology: borrowing lessons from other disciplines

“…There is increased awareness of the need for acute care cardiologists but there remains significant variability in the practice, structure, and staffing of inpatient non-intensive care cardiology. 1,9,[23][24][25] Successful implementation of family-centered care requires resources, training, and expertise. 3 A necessary role that is emerging within cardiology, but needs formalisation, is that of the acute care cardiologist: the attending cardiologist responsible for the care of inpatient children with heart disease who do not require critical care.…”