Poster ID: 39 How is Paediatric Inpatient Care in Canadian Hospitals Structured to Respond to the Needs of Children with Medical Complexity?
Notice bibliographique
Résumé
Abstract Background Children with medical complexity (CMC) have diverse medical diagnoses and the following characteristics: multisystem disease, functional limitations, high care needs, and high healthcare utilization. CMC have intensive inpatient resource use with associated high healthcare costs. Best practices and service delivery models to guide inpatient care of CMC are not yet established and likely vary considerably among institutions. Objectives The objective of this study is to describe the availability and organization of resources for CMC during inpatient care across Canadian paediatric hospitals and assess how these services are adapted to the specific needs of CMC. Design/Methods This environmental scan was conducted as a cross-sectional, researcher-administered virtual survey. The instrument was developed based on a literature review of inpatient complex care and consensus among a panel of content experts. The survey was pilot tested with two complex care physicians and one with expertise in questionnaire development. The survey was available in both English and French. Survey participants were identified through snowball sampling within the Canadian Paediatric Inpatient Research Network (PIRN) with the aim of identifying a key informant from each paediatric hospital. Consistent members of the research team administered survey questions to participants via Zoom, and responses were entered into the Qualtrics platform. Quantitative survey responses were analyzed using univariate descriptive analysis. Qualitative responses were categorized and described for comparative purposes. Results Ten interviews were conducted representing ten different paediatric hospitals. Although nine had established complex care programs, only one of these had a specific inpatient care team for CMC. The physician-to-patient and nurse-to-patient ratios were the same for CMC and non-CMC patients. All sites had some form of standardized documentation to support inpatient care of CMC, but each had different elements and purposes. Only two sites had conducted formal evaluation of their inpatient program for CMC. Key informants rated their hospital’s ability to meet the specific inpatient needs of CMC as a 6.5 out of 10 (on average), with a range of 4-8. Conclusion These results suggest a relative lack of inpatient resources directed to CMC, with a high proportion of sites having a complex care program but with few that include a dedicated inpatient team. Further, there is a lack of standardization across the country in terms of documentation and best practices. Key informants perceive room for improvement in inpatient care at their sites. Future studies will identify evidence-based best practices that can be further evaluated and spread.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,009 | 0,002 |
| Communication savante | 0,004 | 0,001 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,021 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».