From Home to Definitive Care for Critically Ill Children: Barriers and Solutions

Abstract

Optimal outcomes for children with a life-threatening illness or injury depend on early access to care; rapid recognition of the severity of illness with early initiation of appropriate and effective therapy; and optimized and rapid transport to units (such as intensive care units where definitive care can be provided). The details of this process may vary substantially depending on both the context and the underlying disease process which adds to the complexity of providing appropriate systems for children. In addition healthcare systems are frequently designed around the needs of adult patients and optimization of paediatric outcomes requires specific focus on the needs of children. Unfortunately, there are currently multiple barriers to such care, particularly in poorer parts of the world (where the bulk of critically ill or injured children are to be found). Improvement of this situation depends on a process which analyses the pathway to care, identifies challenges and problems in that pathway and provides focussed and system orientated interventions to improve care at all levels and throughout the system.