New Guidelines for Pediatric Surgery Centers Aim to Help Parents Make Informed Choices

Beginning next year, participating children’s surgical centers will be assigned one of three levels of care based on the system used for designating trauma centers, according to a recent article in the Wall Street Journal.

Millions of children undergo surgery in the United States each year, but nearly half of pediatric surgeries are performed in general hospitals with environments not matched to children’s unique needs.

Children and infants, for example, are much more prone to cardiac arrest while under anesthesia. Studies show better outcomes when young patients undergo surgery in specialized pediatric centers.

The guidelines – developed by the Task Force for Children’s Surgical Care, which includes representatives from the American Pediatric Surgical Association, the Society of Pediatric Anesthesia Care, and invited leaders in other pediatric medical specialties – were published in the Journal of the American College of Surgeons. The task force was funded by the college and the Children’s Hospital Association.

“The intent of these recommendations is to ensure that all infants and children in the United States receive care in a surgical environment matched to their individual medical, emotional and social needs,” Keith T. Oldham (MD, FACS), task force chair and surgeon in chief at Children’s Hospital of Wisconsin, said in an American College of Surgeons (ACS) press release.

The ACS plans to assign participating hospitals’ level of pediatric surgical care similar to the way the college classifies trauma centers as Level I (highest level), Level II or Level III. Approximately 200 hospitals will initially participate at a per-hospital cost of around $10,000.

Under the guidelines, all pediatric surgical centers must have a minimum of:

• One pediatric surgical nurse.
• A pediatric rapid-response team of critical care professionals available 24/7.
• An in-house physician with Pediatric Advanced Life Support certification (or equivalent).

Level I centers must be able to perform complex surgeries on newborns and children of all ages, including those with the most severe conditions and birth defects. Level II centers are required to provide advanced surgical care for children of all ages, including those with accompanying medical conditions. Level III centers would provide basic surgical care to children older than 6 months who are otherwise healthy.

Some families wanting optimal surgical care for their child may have to go to a different hospital farther from home. But the added benefit of fewer postoperative risks is a price most parents are probably willing to pay. Some smaller community hospitals, furthermore, will likely add pediatric specialties in response to the verification process, said task force member Dr. David B. Hoyt.

“The goal is to make sure the highest level of care is available for patients with the most complex needs,” Hoyt said.

The attorneys of Morrow Kidman Tinker Macey-Cushman, PLLC represent patients who have been harmed by preventable surgical errors in Seattle and across Washington.