Structure and Functions of Pediatric Aerodigestive Programs: A Consensus Statement

被引：63

作者：

Boesch, R. Paul ^{[1
]}

Balakrishnan, Karthik ^{[1
]}

Acra, Sari ^{[2
]}

Benscoter, Dan T. ^{[3
]}

Cofer, Shelagh A. ^{[1
]}

Collaco, Joseph M. ^{[4
]}

Dahl, John P. ^{[3
]}

Daines, Cori L. ^{[6
]}

DeAlarcon, Alessandro ^{[3
]}

DeBoer, Emily M. ^{[7
]}

Deterding, Robin R. ^{[7
]}

Friedlander, Joel A. ^{[7
]}

Gold, Benjamin D. ^{[8
]}

Grothe, Rayna M. ^{[1
]}

Hart, Catherine K. ^{[3
]}

Kazachkov, Mikhail ^{[9
]}

Lefton-Greif, Maureen A. ^{[4
]}

Miller, Claire Kane ^{[3
]}

Moore, Paul E. ^{[2
]}

Pentiuk, Scott ^{[3
]}

Peterson-Carmichael, Stacey ^{[5
]}

Piccione, Joseph ^{[10
]}

Prager, Jeremy D. ^{[7
]}

Putnam, Philip E. ^{[3
]}

Rosen, Rachel ^{[11
]}

Rutter, Michael J. ^{[3
]}

Ryan, Matthew J. ^{[10
]}

Skinner, Margaret L. ^{[4
]}

Torres-Silva, Cherie ^{[3
]}

Wootten, Christopher T. ^{[2
]}

Zur, Karen B.

Cotton, Robin T. ^{[3
]}

Wood, Robert E. ^{[3
]}

机构：

[1] Mayo Clin Childrens Ctr, Rochester, MN 55905 USA

[2] Monroe Carell Jr Childrens Hosp Vanderbilt, Nashville, TN USA

[3] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA

[4] Johns Hopkins Med Inst, Baltimore, MD 21205 USA

[5] Indiana Univ, Sch Med, Dept Pediat, Riley Hosp Children, Indianapolis, IN 46202 USA

[6] Univ Arizona, Dept Pediat, Tucson, AZ 85721 USA

[7] Univ Colorado, Sch Med, Childrens Hosp Colorado, Dept Pediat, Aurora, CO USA

[8] Childrens Ctr Digest Healthcare LLC, GI Care Kids LLC, Aerodigest Ctr, Childrens Healthcare Atlanta, Atlanta, GA USA

[9] NYU, Langone Med Ctr, New York, NY USA

[10] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[11] Boston Childrens Hosp, Boston, MA USA

来源：

PEDIATRICS | 2018年 / 141卷 / 03期

关键词：

MEDICALLY COMPLEX CHILDREN; INTERSTITIAL LUNG-DISEASE; CLASSIFICATION SCHEME; CYSTIC-FIBROSIS; CARE; HEALTH; GUIDELINES; MANAGEMENT; CENTERS; COSTS;

D O I：

10.1542/peds.2017-1701

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Aerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions. After 3 iterations of survey, consensus was obtained by either a supermajority of 75% or stability in median ranking on 33 of 36 items. This included a standard definition of an aerodigestive patient, level of participation of specific pediatric disciplines in a program, essential components of the care cycle and functions of the program, feeding and swallowing assessment and therapy, procedural scope and volume, research priorities and outcome measures, certification, coding, and funding. We propose the first consensus definition of the aerodigestive care model with specific recommendations regarding associated personnel, infrastructure, research, and outcome measures. We hope that this may provide an initial framework to further standardize care, develop clinical guidelines, and improve outcomes for aerodigestive patients.

引用

页数：9

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