Pediatric Care Recommendations for Freestanding Urgent Care Facilities

Freestanding urgent care centers are in- creasing as a source of after-hours pediatric care. These facilities may be used as an alternative to hospital emer- gency departments for the care and stabilization of seri- ous and critically ill and injured children. The purpose of this policy statement is to provide recommendations for assuring appropriate stabilization in pediatric emergency situations and timely transfer to a hospital for definitive care when necessary. F reestanding urgent care facilities remain a fix- ture in provision of health services in a man- aged care environment. Although the Academy does not approve of the routine use of urgent care facilities because it detracts from the medical home concept, 1,2 the use of these facilities as part of urgent and emergent care systems is increasing in the man- aged care environment. The term urgent care may imply to the public that a facility is capable of man- aging critical or life-threatening emergencies. There- fore, these facilities must have the capability to iden- tify patients with emergency conditions, stabilize them, and provide timely access to definitive care should critically ill or injured children need care. Urgent care facilities must have appropriate pediat- ric equipment and staff trained and experienced to provide critical support for ill and injured children until transferred for definitive care. It is necessary for urgent care facilities to have prearranged access to comprehensive emergency services through transfer and transport agreements to which both facilities adhere. Available and appropriate modes of trans- port should be identified in advance. When after-hours urgent care clinics are used as a resource for pediatric urgent care, they should solicit help from the pediatric professional community, and pediatricians should be accessible who are prepared to assist in the stabilization and management of crit- ically ill and injured children. Pediatricians respon- sible for managing the health care of children may occasionally need to use the resources of urgent care facilities after hours. When such clinics are recom- mended to patients, pediatricians should be certain that the urgent care center is prepared to stabilize and manage critically ill and injured children. RECOMMENDATIONS