All Grown Up
There are times when Dan Hale, MD, FAAP, wishes he had more standardized tools to use when he leads a team of four full-time and four part-time pediatric hospitalists at Central Maine Medical Center (CMMC) in Lewiston. Even after five years at the community hospital, the pediatric HM program still is searching for the best way to hand off patients who are leaving the hospital to their primary-care physicians (PCPs).
It also would be beneficial to have markers against which CMMC could compare itself with similarly sized pediatric HM programs around the country, says Dr. Hale, chief of pediatrics at the medical center. CMMC, which averages about 4,000 patient encounters per year, is one of three hospitals in the state with a pediatric HM program. “It would be nice to see progress being made in these areas,” he says.
Dr. Hale might not have to wait long to see his wishes granted. More than 20 pediatric hospitalists from across the nation met in Chicago earlier this year, intent on developing a strategic framework for pediatric HM (PHM). About 10% of the 30,000-plus hospitalists practicing in the U.S. focus exclusively on pediatrics, according to SHM’s 2007-2008 “Bi-Annual Survey on the State of the Hospital Medicine Movement.” Like the hospitalist movement in general, PHM is growing in number and influence as pediatric hospitalists take on leadership roles and develop working relationships with hospital administrators. The time has come to clearly define the discipline for other physicians, as well as patients and their families, and leverage PHM’s growth and usefulness to improve medical care for children, says Erin Stucky, MD, FHM, a pediatric hospitalist at Rady Children’s Hospital and Health Center in San Diego.
With this dashboard, we want to be able to say, “Here are the things you should look at to ensure quality care for your kids, and as you look at them, you should probably track them over time.”
—Jennifer Daru, MD, FAAP, FHM, chief, division of pediatric hospital medicine, California Pacific Medical Center, San Francisco
“It’s a little bit of pie in the sky, a little bit of rose-colored glasses, but it’s good to aim high,” she says.
Some PHM leaders think the subspecialty has advanced enough in recent years to apply its collective knowledge and influence on a broader stage. “We have gone through our adolescence, and now we are a big community,” says Jack Percelay, MD, MPH, FHM, a pediatric hospitalist at Saint Barnabas Medical Center in New York City and SHM board member. “We’re active at almost all the major medical centers and we need to step up to the plate. We need to start the hard work of bringing our vision to fruition.”
Definition and Strategy
Drs. Stucky and Percelay attended the Pediatric Hospital Medicine (PHM) Strategic Planning Roundtable and serve on the roundtable’s planning committee. SHM, the Academic Pediatric Association (APA), and the American Academy of Pediatrics (AAP) sponsored the gathering, which included young and veteran pediatric hospitalists, clinicians, researchers, and hospitalists from academic, children’s, and community hospitals. The net was cast far and wide to gather information from a broad cross-section of stakeholders.
We have gone through our adolescence and now we are a big community. We’re active at almost all the major medical centers and we need to step up to the plate.
—Jack Percelay, MD, MPH, FHM, pediatric hospitalist, Saint Barnabas Medical Center, New York City, SHM board member
As pediatric hospitalists strive to better demonstrate how they can help hospitals improve the quality of patient care and safety while decreasing its cost, the roundtable is charged with defining and educating healthcare professionals on the key issues. Also in the crosshairs: simultaneously advancing evidence-based medicine and family-based care.
