Care for the hospitalized child has evolved significantly since the term
hospitalist” was first used over 20 years ago. In most pediatric teaching
services, hospitalists care for general pediatric inpatients, but the scope of
practice often extends to comanagement of subspecialty and surgical patients,
as well as coverage in intensive care units and newborn nurseries. Community
hospitals are also employing hospitalists to improve the quality and efficiency
of care while expediting admissions from ambulatory physicians who are not
able to care for inpatients.
Today’s hospitalized children tend to be sicker than before, and care can
be more complicated. As a result of pressures from payers, previously well
patients must now be more seriously ill to justify admission, while children
who require complex care and those who are technology dependent repre-
sent an ever-increasing percentage of inpatients. Furthermore, decreasing
hospitalization days and lengths of stay have become priorities for both
hospitals and insurance companies. At the same time, all parties insist on care
that is safe, efficient, timely, cost-effective, patient centered, and equitable.
The net result is that providing care for the hospitalized child has become
increasingly challenging.
The treatment of pediatric inpatients is addressed in many available
resources, including textbooks, handbooks, and online resources. However,
very few provide concise, specific, point-of-care recommendations about
the most common diagnoses encountered, and none have relied solely on
hospitalists as contributors. This book was conceived as a resource writ-
ten and edited by experts in the field of pediatric hospital medicine, whose
primary focus is the care of hospitalized children. The authors all have
hands-on experience with their topics and represent leaders in the field.
Their practice settings vary from children’s hospitals to private community
hospitals to general pediatric services in public hospitals, so that their recom-
mendations can be used in any of these settings. The clinical chapters are
meant to be directive in immediate care and specific about when to either
escalate care or begin discharge planning.
Written specifically for the hospitalist, this book includes chapters beyond
just clinical care to address the “whole” of a hospitalist’s work. We have
included discussions about activities such as leadership, economics, consent,
and management of the inpatient service and have incorporated other facets of
patient care beyond laboratory tests and treatments. Comprehensive care for
hospitalized children must include attention to medical systems, procedures,
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