Making Time to Coordinate Care for Children With Medical Complexity

* Abbreviation: CMC — : child(ren) with medical complexity The American Academy of Pediatrics’ current policy statement on care coordination1 describes it as a “patient and family-centered, assessment-driven, team-based activity designed to meet the needs of children and youth while enhancing the caregiving capabilities of families.” This framework underscores the aspiration to achieve optimal health and well-being by addressing the child’s “interrelated medical, social, developmental, behavioral, educational, and financial needs.”1 Given the diversity and intensity of these needs among children with medical complexity (CMC),2,3 and a broad vision of health for this population,4 care coordination has become the focus of the rapidly expanding field of complex care.5 Supporting the personnel and infrastructure to successfully coordinate care for CMC is a major sustainability challenge facing complex-care programs today.6 In this month’s issue of Pediatrics , Ronis et al7 report on time spent in nonbillable care coordination activities for 208 CMC over their program’s first 2 years. In near real time, staff logged each coordination activity, the staff’s professional role (eg, registered nurse, medical doctor), and the modality, target, and duration of the … Address correspondence to Ryan J. Coller, MD, MPH, Department of Pediatrics, University of Wisconsin, Madison, 600 Highland Ave, Madison, WI 53792. E-mail: rcoller{at}pediatrics.wisc.edu