Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics

Care for the hospitalized child has evolved significantly since the term hospitalist was first used more than 15 years ago. Most pediatric teaching services use hospitalists for the care of general pediatric inpatients, but the scope of practice often extends to comanagement of subspecialty and surgical patients, as well as coverage in intensive care units and newborn nurseries. Community hospitals are also employing hospitalists to improve the quality and efficiency of care while expediting admissions from ambulatory physicians who are becoming less eager to care for inpatients. Today's hospitalized children tend to be sicker and more complicated than before. As a result of pressures from payers, previously well patients must now be more seriously ill to justify admission, while complex care and technology-dependent children represent an ever-increasing percentage of inpatients. Furthermore, decreasing hospital days and lengths of stay have become priorities for both hospitals and insurance companies. At the same time, all parties insist on care that is safe, efficient, timely, cost- effective, patient-centered, and equitable. The net result is that providing care for the hospitalized child has become increasingly challenging. Written and edited by experts in the field of pediatric hospital medicine, Caring for the Hospitalized Child includes chapters beyond just clinical care to address the whole of a hospitalist's work. It includes discussions about activities, such as leadership, economics, consent, and management of the inpatient service, and incorporates other facets of patient care beyond laboratory tests and treatments. Comprehensive care for hospitalized children must include attention to systems of care, procedures, and ethics, because no sick child exists in a vacuum, and non-bedside activities can have a profound effect on patient outcomes.…