American Academy of Pediatrics Issues New Recommendations on Hospitalized Adolescents

Pediatricians and policymakers help make the hospital experience more suitable for unique needs of teens

The American Academy of Pediatrics has published new recommendations on the needs of adolescents who are hospitalized within its first policy statement on the topic, which is published in the February 2023 issue of Pediatrics.

The statement, “The Hospitalized Adolescent,” published online Monday, Jan. 23, describes how teenagers may be uniquely impacted by hospitalization for acute and chronic illnesses. The policy observes that approximately 1.2 million, or 20%, of all U.S. pediatric hospital admissions are for adolescents between age 11 and 20. These are developmental years most associated with gaining skills in independence, as well as a need for privacy and confidentiality.

An additional clinical report provides more detail on hospital care for adolescents who may have learning, intellectual, or developmental disabilities, with an emphasis on the evaluation of their ability to participate in their care and assent to decisions.

“Teenagers are typically exploring what it means to be independent and so being hospitalized can feel like a real set-back,” said Cora C. Breuner, MD, MPH, FAAP, lead author of the policy statement, written by the Committee on Adolescence, and the Committee on Hospital Care. “There are ways we can help support them, through hospital policies, services and care, and by ensuring that we respect the privacy, confidentiality concerns and dignity of young patients.”

The AAP details an ideal setting for hospitalized adolescents as one that addresses their medical, legal, psychosocial, gender, equity, confidentiality, privacy, and educational needs while maintaining safety and limiting disruptions to their lives and the developmental tasks of typical adolescence.

The AAP recommends:

• Hospital administrations, clinicians and adolescent medicine specialists should assist in the design of hospital settings and in the development of policies for inpatient adolescents.
• Hospitalist training should include adolescent health and wellness.
• Researchers should aggregate demographic data to describe new and ongoing trends in adolescent hospitalizations and to identify where improvements can be made in patient care and physician and staff training.
• Care of adolescents in the hospital setting should be centered around confidentiality. Care providers should be familiar with state confidentiality laws regarding adolescents, privacy, dignity, and respect for adolescent patients and their families.
• Communication between the adolescent’s primary care provider and hospital is essential.
• There should be ongoing anti-racist, anti-microaggression and implicit bias training of physicians and other adolescent hospital caregivers.
• Hospitals should accommodate typical adolescent activities, including education and recreational needs, allowing age-appropriate reading materials, games, music, arts, and electronics.
• Visitation schedules for family and friends should be flexible

“We like to see teens involved in making decisions that affect their health in partnership with family members and the medical team,” Dr. Breuner said. “During challenging circumstances, adolescents deserve our compassion, respect and support.”

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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.