A Workforce Survey on Developmental-Behavioral Pediatrics.

BACKGROUND AND OBJECTIVES: Developmental-behavioral conditions are common, affecting ∼15% of US children. The prevalence and complexity of these conditions are increasing despite long wait times and a limited pipeline of new providers. We surveyed a convenience sample of the developmental-behavioral pediatric (DBP) workforce to determine current practices, workforce trends, and future needs. METHODS: An electronic survey was e-mailed to 1568 members of the American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics and Council on Children with Disabilities, the Society for Developmental and Behavioral Pediatrics, and the National Association of Pediatric Nurse Practitioners Developmental and Behavioral Mental Health Special Interest Group. RESULTS: The response rate was 48%. There were 411 fellowship-trained physicians, 147 nonfellowship-trained physicians, and 125 nurse practitioners; 61% were women, 79% were white, and 5% were Hispanic. Physicians had a mean of 29 years since medical school graduation, and one-third planned to retire in 3 to 5 years. Nurse practitioners were earlier in their careers. Respondents reported long wait times for new appointments, clinician burnout, increased patient complexity and up to 50% additional time spent per visit in nonreimbursed clinical-care activities. Female subspecialists spent more time per visit in billable and nonbillable components of clinical care. CONCLUSIONS: The DBP workforce struggles to meet current service demands, with long waits for appointments, increased complexity, and high volumes of nonreimbursed care. Sex-based practice differences must be considered in future planning. The viability of the DBP subspecialty requires strategies to maintain and expand the workforce, improve clinical efficiency, and prevent burnout.

Practice Patterns in Pediatric Critical Care Medicine: Results of a Workforce Survey.

OBJECTIVE: To obtain current data on practice patterns of the U.S. pediatric critical care medicine workforce. DATA SOURCES: Membership of the American Academy of Pediatrics Section on Critical Care and individuals certified by the American Board of Pediatrics in pediatric critical care medicine. STUDY SELECTION: All active members of the American Academy of Pediatrics Section on Critical Care, and nonduplicative individuals certified by the American Board of Pediatrics in pediatric critical care medicine, were classified as eligible to participate in this electronically administered workforce survey. DATA EXTRACTION: Data were extracted by a doctorate-level research professional. Extracted data included demographic information, work environment, number of hours worked, training, clinical responsibilities, work satisfaction and burnout, and plans to leave the practice of pediatric critical care medicine. DATA SYNTHESIS: Of 1,857 individuals contacted, 923 completed the survey (49.7%). The majority of respondents were white, male, non-Hispanic, university-employed, and taught residents. Respondents who worked full time were on clinical intensive care service for a median of 15 wk/yr and responsible for a median of 13 ICU beds, working a median of 60 hr/wk. Total night call responsibility was a median of 60 nights/yr; about half of respondents indicated night call was in-hospital. Fewer than half were engaged in basic science or clinical research. Compared with earlier data, there was minimal change in work hours and proportion of time devoted to research, but there was an increase in the proportion of female pediatric critical care medicine physicians. CONCLUSIONS: These data provide a description of the typical intensivist and a snapshot of the current pediatric critical care medicine workforce, which may be experiencing a mild-to-moderate undersupply. The results are useful for assessing the current workforce and valuable for future planning.

The US pediatric nephrology workforce: a report commissioned by the American Academy of Pediatrics.

The US pediatric nephrology workforce is poorly characterized. This report describes clinical and nonclinical activities, motivations and disincentives to a career in pediatric nephrology, future workforce needs, trainee recruitment, and possible explanations for personnel shortages. An e-mail survey was sent in 2013 to all identified US-trained or -practicing pediatric nephrologists. Of 504 respondents, 51% are men, 66% are US graduates, and 73% work in an academic setting. About 20% of trained pediatric nephrologists no longer practice pediatric nephrology. Among the 384 respondents practicing pediatric nephrology full or part-time in the United States, the mean work week was 56.1±14.3 hours, with time divided between patient care (59%), administration (13%), teaching (10%), clinical research (9%), basic research (6%), and other medical activities (3%). Most (>85%) care for dialysis and transplantation patients. The median number of weeks annually on call is 16, and 29% work with one or no partner. One-third of US pediatric nephrologists (n=126) plan to reduce or stop clinical nephrology practice in the next 5 years, and 53% plan to fully or partially retire. Almost half the division chiefs (47%) report inadequate physician staffing. Ongoing efforts to monitor and address pediatric nephrology workforce issues are needed.

Transition Planning for Youth With Special Health Care Needs (YSHCN) in Illinois Schools.

"Transition Planning for Youth with Special Health Care Needs (YSHCN)" chronicles the research and work completed by agencies in Illinois to provide examples of best practice in transition planning. Increasing numbers of YSHCN survive into adulthood creating a need for focus on the transition to adult life for these young people, including meeting health care needs. As a part of the Transitions project, the Illinois Chapter of the American Academy of Pediatrics and the University of Illinois at Chicago Division of Specialized Care for Children surveyed Illinois public high schools to identify transition planning efforts, staff training needs and used those results to develop and implement training. A natural way to organize health services is by integration with school transition services. The credentialed school nurse would be the ideal person to contribute to the development of the health care transition plans based on the student's heath care provider's medical management plan.

Feeling at home in one's school: a first look at a new measure.

We report on the development of the Hospitality Scale, which measures two aspects of adolescents' perception of social capital in school-the extent to which they perceive that they have social capital and the extent to which they provide social capital to others. The scale was developed in reference to the literature exploring adolescent social isolation and social tolerance, as well as constructs developed in research on adults, especially related to psychological sense of community and collective efficacy. We examine the reliability of the scale and the association between scale scores and behavioral factors that may reflect social isolation.