American Academy of Pediatrics: Best Care for Children Remains at the Pediatrician's Office

​The Academy recommends that physicians coordinate with urgent care and retail-based clinics, to ensure high-quality services outside the medical home.

The American Academy of Pediatrics affirms its stance that the ideal location for children to receive care for acute, nonemergency health concerns is at a pediatrician's office or similar "medical home" that offers continuous, comprehensive and coordinated care, according to a newly released policy statement.

The Academy also acknowledges the need to coordinate with and help improve standards at a growing number of urgent care facilities, retail-based clinics and commercial telemedicine services that are used by some families because of a perceived or real benefit in accessibility, convenience or cost.

"Children deserve to receive care from a skilled professional, a physician who knows their needs and medical history, who works alongside family members to keep them safe and healthy," said Susan Kressly, MD, a lead author of the policy statement.

"While families may sometimes feel the need to seek medical care at retail centers or elsewhere outside the doctor's office, we remain concerned that the treatment delivered at many of those facilities falls short of evidence-based medical standards."

The report, "Nonemergency Acute Care: When It's Not the Medical Home," to be published in the May 2017 issue of Pediatrics (online April 24), replaces two previously published policy statements that addressed the expanding models of acute care services. The updated statement emphasizes that treatment of children at established, evolving and new practices should adhere to core principles that are based on recommendations that include:

• Maximize continuity of care by rapidly communicating information and referring the child for necessary follow-up to the medical home.
  Provide care that is based on the best available evidence and have clearly defined limits of scope of service that are transparent to families.
• Ensure that the staff have pediatric training and experience.
• Establish protocols for in-person and technology-enabled care for transitions of care during emergencies, during situations outside scope of care, and for after-hours coverage.
  Put in place strategies for continuous assessment and improvement for quality of care and patient safety.

The Academy recommends that children younger than 2 years old are not treated at retail-based clinics or acute care services that lack pediatric expertise. The policy statement encourages pediatric practices to use innovative ways to meet family needs within the medical home, such as by increasing hours of operation.

The medical home remains the best location for children and adolescents to receive care for chronic or complex conditions, including behavioral health issues; for routine well-child care, including physical examinations and immunizations; and for whole-person care, including issues affected by social determinants of health.

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The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds.