American Academy of Pediatrics Details Need for Pediatric Intermediate Care Units

More children are living longer after surviving critical illness, in part due to pediatric medical care improvements over the past two decades. The American Academy of Pediatrics, in an updated policy statement, describes the need to address the changes in children’s hospital care with recommendations on establishing pediatric intermediate care units. The new policy statement, “Guidance for Structuring a Pediatric Intermediate Care Unit,” will be published in the May 2022 Pediatrics (published online April 18). A nine-member task force representing the AAP Section on Critical Care, Committee on Hospital Care, and Section on Surgery produced the policy statement, which updates recommendations last written in 2004. Recommendations call for hospitals or health systems to design clear, comprehensive triage guidelines to guide admission to and care within a pediatric intermediate care unit (IMCU), as well as clear delineations on when children should be treated in an IMCU versus a pediatric intensive care unit. The statement observes that pediatric patient populations well served by an IMCU model may include children with acute critical illness, children with complex chronic disease, and a range of pediatric surgical patients. The statement observes the need for specially trained pediatric staff, care managers, and social workers as well as a nurse-to-patient ratio at 1:2 or 1:3 to care for pediatric IMCU patients. The policy statement advocates for national CMS recognition of the IMCU level of care with associated hospital payment. The new statement is intended for institutions, administrators, providers, health care funders, and policy makers in all settings, including rural and urban hospitals and major academic centers.

###

The American Academy of Pediatrics is an organization of 67,000 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.