Funded Projects

Caring for Children with Chronic Conditions

Project Year

2025

City & State

Houston, Texas

Program Name

CATCH Resident

Topic

CSHCN/Disabilities

Program Description

Problem: Residents are not well-equipped to care for children with complex illnesses which further translates to poor health outcomes for these children. Since this patient population requires multi-systemic and multi-disciplinary needs, pediatric residents should have established integrated teaching on both the medical, developmental, and psychosocial aspects of serving this vulnerable population.    Primary setting: This project will take place in Harris County in Houston, TX, home to the Texas Medical Center, where a large population of children with medical complexity receive their primary care.    Number of children affected: As stated by McGovern Medicine at UTHealth Houston, in 2018, 0.4% of children classify as medically complex, however they account for 40% of pediatric deaths and 53% of pediatric hospital charges. According to the Maternal and Child Health Bureau, in 2021, approximately 1.2 million or 1.5% of children have medical complexities. In one of our Chronic Care clinics, we serve around 400 patients.    Project goal: The project goal is to develop a partnership with local organization Project Delivery of Chronic Care Houston (Project DOCC Houston) to promote community between pediatric providers and children with chronic care needs and their caregivers, and to implement educational sessions on caring for these children during resident lectures.   Proposed intervention: Residents do not have focused education on serving this population prior to treating them when they are acutely ill. Based on a survey I disseminated (see supplemental attachments), my co-residents have similar sentiments regarding lack of additional formal teaching on managing children with chronic conditions. There are two components to this project: the first involves community outreach with Project DOCC Houston to establish rapport between pediatric trainees and patients with chronic care needs and their caregivers, as well as becoming more knowledgeable on their daily life after they leave the medical setting. We will conduct two 1-hour virtual focus groups, at the beginning and end of the grant period, with families to identify health issues and education gaps to address during the duration of our project. We will implement pre- and post-intervention assessments to track our progress. Moreover, we will organize two community events with pediatric residents and children with chronic conditions and their families to build community rapport and to develop connections outside of the medical setting.   The subsequent section involves focused resident teaching on popular topics in caring for children with chronic care needs. We will establish four 1-hour Chronic Care Chats led by our attendings during our resident lectures on 1) case management and transition to adulthood, 2) occupational and physical therapies, physical medicine and rehabilitation, and durable medical equipment, 3) palliative care, 4) and common gastrointestinal concerns and nutrition. We will do pre- and post-assessments during each session to evaluate resident comprehension.   Anticipated outcomes: I anticipate that this project will enhance treatment outcomes and patient and family satisfaction. Due to improved medical technology and patient management, this population is continuously growing, and the patients have a longer life expectancy; therefore, most residents will encounter these patients in their clinical practice. Through this project, residents will become more proficient in treating children with chronic conditions, which will improve treatment outcomes because they will have an increased understanding on how to navigate the multidisciplinary requirements of this patient population. When residents engage with children and their families through community outreach, they will form a better understanding of the daily lives of families as caregivers, which will increase empathy in their practice. Additionally, since this project will receive feedback from caregivers during the focus groups as well as encourage community bonding through community events, it will ameliorate satisfaction of patients and their families.

Project Goal

Partner with a chronic care organization to promote community rapport between pediatric providers and children with medical complexity and their caregivers and implement Chronic Care Chats during resident educational lectures.

Project Objective 1

Teach 4 one-hour presentations on chronic care topics to 40 residents at resident lectures and see a 25% increase on chronic care knowledge from pre- and post-test surveys from July-November 2025.

Project Objective 2

Establish partnership with community partner by November 2025 and host 2 community events and 2 virtual caregiver focus groups by June 2026.

Project Objective 3

Identify 3 caregivers who will mentor residents on their daily experiences by December 2025 and demonstrate improvement of family satisfaction through pre- and post-intervention surveys by June 2026.

AAP District

District VII

Institutional Name

University of Texas Health Science Center at Houston

Contact 1

Dominique Dagdag, MD