Blog Post

The Unique Nuances of Pediatric Care: Access Challenges

The Unique Nuances Web

Navigating the healthcare industry can be a challenge on its own. For parents or other caretakers of children, the additional concerns about addressing their child’s pain, finding a timely appointment, and coordinating between work and school schedules can make the task of taking a child to see a provider seem nearly impossible.

Fortunately, healthcare organizations can ease this process for pediatric patients, their families, and providers. These steps will ultimately differentiate pediatric programs in the marketplace, generating revenue and—most importantly—providing timely and appropriate care for the next generation.

1. The Challenges of Accessing Pediatric Healthcare

Table 1: Challenges in Pediatric Healthcare


1. Results and Data: 2019 Main Residency Match (National Resident Matching Program; Washington, DC; April 2019).
2. Ibid.
3. James Dalen et al., “Where Have the Generalists Gone? They Became Specialists, Then Subspecialists” (American Journal of Medicine, February 2017).
4. James Perrin et al., “The Rise in Chronic Conditions among Infants, Children, and Youth Can Be Met with Continued Health System Innovations” (Health Affairs, December 2014).
6. “How Are Children Different from Adults?” (Centers for Disease Control and Prevention, September 1, 2020).>

2. Strategies to Address Pediatric Access Challenges

For the families of pediatric patients, accessing care—including identifying a provider, scheduling an appointment, navigating the care system, and communicating with the care team—can be stressful and time-consuming. Pediatric hospitals and health systems with a pediatric component should consider patient access a strategic imperative. Below are pediatric-focused access strategies that hospitals and health systems can develop to address this imperative and improve the patient family experience.

  • Redesign provider templates with the patient family in mind.
    • In primary care, slots should be held for well-child checks, sick patients, and new/newborn patients. The provider’s panel size should determine how many slots are held, and at least half of the slots should be open for any appointment type. Additionally, there should be a protocol for scheduling consecutive appointments for siblings.
    • In specialty care, time should be reserved as appropriate for interdisciplinary clinics. On an ad hoc basis, practices should reserve sessions in advance when providers are in clinic together.
    • As space and staffing allow, all types of practices should consider expanding hours of operation to weeknights and weekends, as shown in figure 1, to accommodate for work and school schedules.
Figure 1: Sample clinic Hours of Operation and Opportunities for Extended Hours
  • Create timely access to care when possible.
    • Establish a new-patient clinic in specialties where wait times are weeks or months out. These can be staffed by APPs or rotating physicians who can refer to the appropriate physician internally.
    • Hold slots for new patients, especially in specialties where there is urgency to see a provider upon initial diagnosis (e.g., oncology, orthopedics).
    • Refine centralized access, capacity, and referral management programs. By creating programs that can provide a prospective view of capacity and navigate referrals to the appropriate area based on diagnosis, urgency, and availability, pediatric institutions can direct patient families to the appropriate physician internally.
    • Collaborate with pediatricians to identify when to refer to which specialist. Some specialties may be overreferred and can be appropriately managed by the patient’s pediatrician, allowing additional access for more clinically urgent patients.
  • Utilize technology to collaborate across specialties.
    • Create a program to close the loop on all referrals, ensuring that the pediatrician has all available information to resume the child’s care in their next checkup or upon transition out of the specialty.
    • Adopt health information exchange programs and strategies so patient families do not need to bear the burden of finding health records from previous providers.
  • Make communicating with the care team easy.
    • Utilize a patient portal so patient families can see results, view and schedule appointments, and message their care team.
    • Reach out to the patient family between visits to proactively manage concerns and ask questions.
  • Utilize the full care team to care for the child’s needs:
    • APPs to treat less-complex patients and/or staff a new-patient triage clinic
    • RNs to handle patient communication and outreach
    • Educators and coordinators to navigate care with families

3. Pediatric Access as a Competitive Advantage

A lack of access to clinical care and communication is an issue across pediatrics in the US, and it is a challenge for health systems across the country to provide timely pediatric care, especially for specialty and subspecialty care. By looking at access through the lens of pediatric patient, family, and provider needs, organizations can find effective solutions to combat the challenges they face in the pediatric space.

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