Canadian paediatric tertiary care hospitals’ response to the needs of children with medical complexity during acute visits and hospitalisations: A landscape study
Bibliographic record
Abstract
Background: Children with medical complexity (CMC) have unique specialized needs accessing and receiving care in paediatric hospitals. Objectives: To identify the organizational resources available for the care of CMC in Canadian tertiary care paediatric hospitals and to assess key informants' understanding of how these resources are adapted to CMC's needs. Methods: For this environmental scan, key informants representing paediatric hospital medicine/complex care (PHM/CC) and paediatric emergency medicine (PEM) from all 15 Canadian tertiary care paediatric hospitals completed questionnaires. Participants were identified through national research networks. Following Burns methodology, two novel survey tools were developed and administered via a teleconference or electronically. Results: = 30, response rate: 100%). Most (12/15) hospitals had a CC program; of those with a program, 9/12 offered inpatient and outpatient services. For hospitalized CMC, few hospitals had CC dedicated wards (2/15) or healthcare professionals (4/15). Although 10/12 CC programs reported offering a consultation service to their emergency department (ED), most (9/10) were only available on weekdays. PHM/CC respondents believed their inpatient CC team communicated and coordinated effectively (9/12) and facilitated continuity of care (6/12). PEM respondents suggested improving access to patients' documents (10/15), improving CC program availability (8/15) and adapting ED physical spaces (7/15). Conclusions: Most Canadian paediatric tertiary care hospitals have a CC program, but their resources and availability vary. There are many opportunities for improvement for the ED and inpatient care of CMC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.007 |
| Science and technology studies | 0.006 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".