Guidance for Structuring a Pediatric Intermediate Care Unit

Author:

Ettinger Nicholas A.1,Hill Vanessa L.2,Russ Christiana M.34,Rakoczy Katherine J.5,Fallat Mary E.6,Wright Tiffany N.6,Choong Karen7,Agus Michael S.D.4,Hsu Benson8,

Affiliation:

1. Section of Critical Care, Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, Texas

2. Section of Pediatric Hospital Medicine, Department of Pediatrics, Baylor College of Medicine/The Children’s Hospital of San Antonio, San Antonio, Texas

3. Intermediate Care Program

4. Division of Medical Critical Care, Boston Children’s Hospital, Boston, Massachusetts

5. Section of Pediatric Hospital Medicine, Department of Pediatrics, Tuft’s Children’s Hospital, Boston, Massachusetts

6. Division of Pediatric Surgery, Hiram C. Polk Jr Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky

7. Division of Critical Care, Department of Pediatrics, McMaster University, Ontario, Canada

8. Division of Critical Care, Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota

Abstract

The purpose of this policy statement is to update the 2004 American Academy of Pediatrics clinical report and provide enhanced guidance for institutions, administrators, and providers in the development and operation of a pediatric intermediate care unit (IMCU). Since 2004, there have been significant advances in pediatric medical, surgical, and critical care that have resulted in an evolution in the acuity and complexity of children potentially requiring IMCU admission. A group of 9 clinical experts in pediatric critical care, hospital medicine, intermediate care, and surgery developed a consensus on priority topics requiring updates, reviewed the relevant evidence, and, through a series of virtual meetings, developed the document. The intended audience of this policy statement is broad and includes pediatric critical care professionals, pediatric hospitalists, pediatric surgeons, other pediatric medical and surgical subspecialists, general pediatricians, nurses, social workers, care coordinators, hospital administrators, health care funders, and policymakers, primarily in resource-rich settings. Key priority topics were delineation of core principles for an IMCU, clarification of target populations, staffing recommendations, and payment.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference34 articles.

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3. NHS England . Schedule 2 - the services. Available at: https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/01/eo7-sb-paed-hig-dep- care.pdf. Accessed August 31, 2021

4. Criteria for critical care infants and children: PICU admission, discharge, and triage practice statement and levels of care guidance;Frankel;Pediatr Crit Care Med,2019

5. Executive summary: criteria for critical care of infants and children: PICU admission, discharge, and triage practice statement and levels of care guidance;Hsu;Pediatrics,2019

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