275 - Multistakeholder consensus on essential knowledge, skills, and attitudes of pediatricians in post-acute care of children with medical complexity

Publication Number: 275.5970

Jennifer Perez, Boston Children's Hospital, Boston, MA, United States; Elisabeth G. Schainker, Franciscan Childrens, Cambridge, MA, United States; Mary C. Summers, Tufts University School of Medicine, Braintree, MA, United States; Kathleen Huth, Boston Children's Hospital / Harvard Medical School, Boston, MA, United States

Background: Children with medical complexity (CMC) are a growing patient population with highly specialized needs, cared for by pediatricians in hospital and community settings. Ensuring that future pediatricians are able to provide high-quality care for patients in post-acute care settings is of critical importance to optimize clinical outcomes for CMC. An Entrustable Professional Activity (EPA) framework can be used to formally describe the role of pediatricians in post-acute care of CMC.

Objective: To define essential knowledge, skills, and attitudes for pediatricians in post-acute care through multistakeholder consensus—with the ultimate goal of informing the development of an EPA in post-acute care of CMC.

Design/Methods: A multidisciplinary stakeholder consensus conference was held in February 2024. Participants were identified through purposeful sampling based on experience caring for CMC in the post-acute care setting and experience with pediatrics residency training. Nominal Group Technique (NGT) was used to generate, discuss, and prioritize ideas. An individual voting process was used to identify a list of learning objectives as ‘essential’, ‘important, but not essential’, or ‘not important’ for pediatricians. Consensus was defined as items identified as “essential” by at least 70% of participants.

Results: There were 15 participants in the consensus conference, including a family caregiver with lived experience, pediatric resource specialists, pediatric residents and residency program director, medical subspecialists, and interprofessional team members from a post-acute care facility, including a physician, psychologist, nurse case manager, family advocate, and nurse practitioners. Forty-four learning objectives were generated in the following domains: nature and goals of post-acute care, practices of referring and transitioning patients to/from post-acute care, communication and setting expectations, family and community supports and services, patient- and family-centered care, and medical technology. Consensus was achieved for 20 learning objectives (Figure 1). A final list of consensus statements is presented in Table 1.

Conclusion(s): An expert panel including members of the interprofessional care team and a family partner identified essential knowledge, skills, and attitudes in post-acute care of CMC. These findings will inform the development of an EPA with rich description that can guide curriculum development and assessment for pediatricians in this important area of clinical practice.

Table 1: Consensus statements on the essential knowledge, skills and attitudes of pediatricians in post-acute care of children with medical complexity.
Table 1.pdf

Figure 1: Plot with number and percent of participants identifying items as essential, important, or not important.
Figure1.pdfThe black line in the figure denotes consensus criteria of 70% identifying objectives as ‘essential’. Consensus was achieved for 20 of 44 learning objectives.