Pediatric Extended Care

Prescribed Pediatric Extended Care (PPEC) centers are specifically designed to decrease health care costs by delivering cost effective health services to children with medically complex conditions, in the hopes of reducing frequent hospitalizations. Parents who enroll their children in PPECs not only expect the management of their child’s medical needs, but also anticipate that the PPEC will function as a regular daycare and promote their child’s academic and social development. Hence, the expectation placed on PPECs is double of that of a regular daycare. PATCHES Inc., a PPEC, offers medical treatment, therapy, and education to children with complex medical conditions. However, given that PATCHES is functioning within a system with severe
Caregivers working with a group of nonambulatory teens have different stressors and challenges compared to caregivers taking care of nonambulatory infants. One specific challenge is having the increased risk of incurring injuries while lifting, cleaning, and feeding older children. Since the number of caregivers within these groups cannot increase due to budget constraints, the caregivers must therefore change their level of care in order to avoid incurring injuries that could put them at risk for expensive medical treatment or days out of work. In order to lessen their workload, the caregivers will place the children in their cribs for a greater portion of their 12-hour shift day. This will then lead to limited social and physical interactions between the child and his/her surrounding environment. Furthermore, overworking the caregivers unintentionally negatively affects the “well behaved” or “quiet” children, since most of the attention and effort will be shifted toward the children who are more vocal and demanding. While these adjustments decrease the negative externalities experienced by caregivers, it often means a loss in the quality of care for the
Although provider burnout exists amongst certain personnel, overall burn out is low, and the staff is still able to maintain their professionalism and dedication to their work. Continuous communication between the parents and the caregivers allows for constant updates on the latest changes in the child’s medical treatment and a medium by which each side can express concerns. Furthermore, a team of therapist at PATCHES meets with each child on a daily basis to strengthen their motor and speech skills. Although PATCHES lacks the psychiatric centered care that could cope with the neurodevelopmental disorders that are sometimes comorbid with certain congenital conditions, it is rather a deficiency within the PPEC design rather than a flaw exclusive to PATCHES. This is due to the PPEC model focusing on the cost effective management of chronic medical conditions, rather than the optimization of social and academic development in children with neurodevelopmental disorders. Nevertheless, PPECs such as PATCHES remain strong contenders in the move toward increasing the quality of life and extending the life expectancy of children with medically complex