by Sean Ruck
, Contributing Editor | June 12, 2014
From the June 2014 issue of HealthCare Business News magazine
DOTmed HealthCare Business News spoke with Amy Knight, COO
for CHA to learn about the the challenges unique to caring for children in a clinical setting.
HCBN: This may seem like a silly question, but let’s get it out of the way — what is a child?
Generally, depending on who you’re talking to, most hospitals will look at up to 18 or 21 years old and under as a child. But when you look at some subsets like orthopedics, some adult specialists will treat children like adults — like a 14 year-old football player . . . some of those kids are big for their age and treated like men when it comes to that care. This is not always ideal, given the physiologic and developmental needs.
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Still, some hospitals may extend the age of the patients they handle. For instance, children with lifelong complexities, there’s a real challenge in transitioning some of these kids that might be 24 or 25 in physiological age, but developmentally they’re still very much children. And that’s becoming more common. Babies are surviving — that 20 or 30 years ago wouldn’t have — and while many go on to lead successful lives, others have lifelong challenges.
HCBN: What does it mean to be considered a children’s hospital?
There’s a wide range of types and sizes of children’s hospitals and the classes of memberships we have define some of those differences, but it can be challenging to define sometimes. Hospitals may be freestanding, part of a large academic medical center, or part of a larger hospital. They may be for profit or not-for-profit. Some members may have 50 or 60 beds set aside for children, others may have hundreds of dedicated beds and infrastructure.
But they all have the same basic criteria. Their mission is to take care of all, not some children. Most have some level of teaching and research and community service. At their core, they have to demonstrate a certain level of commitment and service to the children within their community.
HCBN: What challenges are unique to children’s hospitals?
It’s cliché to some degree, but children aren’t little adults. Equipment is often different and they’re resource-intensive. Caring for them often requires extra square footage in the units they’re in because you’re not just treating the child — the family may be there as well, the mom and dad, siblings — and they may be there for an extended period of time. The knowledge required also differs. A common complaint we hear from children hospitals that are part of a larger system is that they might have to share ORs with adult patients and specialists. So, depending on the schedule, a pediatric anesthesiologist, may be unavailable.