title: Pediatric hospitalists' perspectives on the care of children with medical complexity.
abstract: OBJECTIVE
  The aims of this study were to identify pediatric hospitalists' perceived views of (1) barriers to delivering care to children with medical complexity (CMC) and (2) their preferred model of inpatient health care delivery for CMC.
  
  
  METHODS
  American Academy of Pediatrics Section on Hospital Medicine (AAP-SOHM) Listserv subscribers.
  
  
  METHODS
  We conducted a cross-sectional survey of subscribers of the AAP-SOHM Listserv using the survey instrument SurveyMonkey®. Our survey was coadministered with a survey on pediatric hospitalist career satisfaction.
  
  
  RESULTS
  The most significant barriers to delivering care to CMC were (1) time constraints (89%), (2) inadequate postdischarge resources (75%), and (3) lack of evidence-based guidelines (64%). Although most pediatric hospitalists in an inpatient service currently care for both CMC and non-CMC patients (91%), only 25% perceive this to be the optimal service model for CMC. The majority of hospitalists (56%) believe that CMC are better served by either an inpatient service dedicated to CMC (30%) or comanaged with an inpatient consult service for CMC (26%).
  
  
  CONCLUSIONS
  Identifying the perceived barriers to delivering care to CMC can assist pediatric hospitalists to design studies determining if care delivery is affected by these barriers. Most hospitalists care for CMC on the same service as uncomplicated patients, yet over half perceive that a different model of care delivery would better serve the needs of CMC.
authors: University of Texas Health Science Center San Antonio, Department of Pediatrics, Division of Inpatient Pediatrics, San Antonio, Texas.
authors: Noemi
authors: N
authors: Adame
authors: Mary E M
authors: ME
authors: Rocha
authors: Chris
authors: C
authors: Louden
authors: Rishi
authors: R
authors: Agrawal
keywords: CMC; Children with medical complexity; best model of care delivery for CMC; perceived barriers to delivering care to CMC