The Committee on Pediatric Emergency Medicine of the American Academy of Pediatrics (AAP) has released a policy statement that provides recommendations to guide the care of young patients in emergency situations and the timely transfer from urgent care facilities to the hospital when necessary. “Pediatric Care Recommendations for Freestanding Urgent Care Facilities” appears in the July 2005 issue of Pediatrics and is available online at http://www.pediatrics.org.
The AAP does not recommend the use of urgent care facilities because it may undermine coordinated, comprehensive care; however, these facilities often are needed in emergency situations. Although freestanding urgent care facilities are not the same as hospital emergency departments, the AAP stresses that they must have the ability to identify emergency medical situations, stabilize patients, and coordinate timely access to definitive care.
The policy statement includes the following recommendations for urgent care facilities that provide emergency care for children:
Staff should be able to provide resuscitation, stabilization, triage, and appropriate transfer.
Facilities should meet the AAP minimum requirements for medications, equipment, and supplies as listed in “Care of Children in the Emergency Department: Guidelines for Preparedness” issued by the AAP and the American College of Emergency Physicians (http://aappolicy.aappublications.org/cgi/reprint/pediatrics;107/4/777.pdf).
Facilities must have staff certified in basic and advanced pediatric life support available at all times.
Facilities should have triage, transport, and transfer agreements with definitive care facilities.
Facilities should have a plan that complies with the Health Insurance Portability and Accountability Act for notifying the primary care physician about the treatment given.
Facilities should have an organized quality-improvement program.
Facilities should comply with the policies, procedures, and protocols listed in “Care of Children in the Emergency Department: Guidelines to Preparedness.”
Facilities should have a disaster preparedness policy and participate in their community disaster plan.
The AAP also recommends that physicians who refer patients to urgent care facilities provide each patient’s clinical information to the facility and be available for consultation.