NATIONAL HARBOR, MD. — After an 8-year development effort, the Society of Hospital Medicine has published core competencies for pediatric hospitalists.
The competencies define the expected standards for all pediatric hospitalists, regardless of their practice setting or location, said Dr. Mary C. Ottolini of the SHM's pediatric committee. They are also a means of differentiating hospitalists from primary care pediatricians or other pediatric specialists, she said.
Although the competencies are viewed as the first step in gaining recognition as a new specialty through the American Board of Pediatrics, it is not guaranteed that a certification process will be forthcoming soon, Dr. Ottolini said at the annual meeting of the Society of Hospital Medicine.
Coauthor Dr. Erin R. Stucky of Rady Children's Hospital and the University of California, San Diego, said that negotiations with the ABP are ongoing.
The American Board of Pediatrics, however, has not been petitioned to consider a new pediatric hospitalist subspecialty, according to Dr. James A. Stockman III, president and CEO of the board. In the absence of a petition, the board will not formally weigh the pros and cons of introducing such certification, he noted in an interview.
The American Board of Internal Medicine and the American Board of Family Practice have chosen to offer Recognition of Focused Practice in Hospital Medicine, a credential available for the first time in 2010. The new certification requirements will be met through an exam, along with self-evaluation and practice improvement modules to be completed as part of the maintenance of certification process. But the ABP is not certain that such a mechanism would be appropriate for pediatrics, Dr. Stockman said.
Many hospitalists thought that the competencies had already been published because a development framework was published in 2006, noted Dr. Ottolini of Children's National Medical Center and George Washington University, both in Washington. In the years since the SHM's pediatric core competencies task force was created, there have been many iterations, corrections, and reviews, she said.
The final publication contains 54 chapters covering 22 common clinical diagnoses, 6 specialized clinical services, 13 core skills, and 13 health care systems for supporting and advancing child health (J. Hosp. Med. 2010 April 9 [doi:10.1002/jhm.776
The common clinical conditions were taken from nonsurgical data collected by the Joint Commission and publications on common pediatric hospitalizations. The specialized services include care that is not based on diagnosis-related group data. The core skills come from the Healthcare Cost and Utilization Project Factbook and randomly selected hospitalist billing data.
The competencies are not meant to be all inclusive, rigid, or easily achieved during residency training, Dr. Ottolini said.
They may even be difficult to achieve during a fellowship, Dr. Stucky added.
In an extensive collaborative process, the competencies were reviewed by 9 section editors, 50-plus authors and contributors, 3 senior editors, 33 internal reviewers, and dozens of external reviewers, including all the major academic and certifying societies, “stakeholder” agencies such as the American Hospital Association and the American College of Emergency Physicians, and pediatric hospital medicine fellowship directors at major children's hospitals around the country.
Dr. Ottolini said that she thought the competencies would be used in a variety of ways, including by educators to help develop curricula, by those new to the specialty to increase their knowledge, by physicians as a marketing tool, and by physician groups as a means of recruiting new partners.
Disclosures: None was reported.
The core competencies are not meant to be all inclusive, rigid, or easily achieved during residency.
Source DR. OTTOLINI