UCA 2018: Kids Are Not Just Little Adults

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This was my second Urgent Care Association (UCA) conference to serve as a speaker, but the first time I was asked to speak on pediatric care. Last year it was about patient satisfaction and wait times – an obvious topic of interest to the urgent care business crowd. This year, not only was I getting to talk about pediatric care, but there was an entire pediatric clinical care track!

Almost a quarter of patients who present in urgent care are minors. The most common complaints are similar to children who present in the emergency department. However, the setting of urgent care is not staffed in the way an emergency department is to care for children. First, urgent cares are largely staffed without registered nurses, instead using more cost-conscious staffing with medical assistants, certified nurse assistants, or licensed practicing nurses. Furthermore, the provider's training varies widely from emergency medicine boarded physicians to advanced practice providers.

The New Frontiers UCA Fall Conference in Houston, Texas hosted pediatric physicians and advanced practice providers to speak on pediatric care topics about gastrointestinal diseases, dermatologic issues, eye complaints, and interesting clinical cases. I had the opportunity to share information about pediatric asthma presentations, treatment, and management. My goal was to empower generalists in urgent care to confidently care for mild to moderate asthma attacks in their setting. The other lecture topic was, 'Among the Ponies, Zebra Foals: Pediatric Clinical Cases to Overcome Cognitive Biases and Avoid Diagnostic Error.' The fast-paced, patient-centered urgent care setting lends itself to be an environment rich in opportunities for medical errors. This lecture highlighted potential causes and possible strategies to mitigate error especially when the patient is a child.

Beyond the lectures (available as webinars) to share knowledge about pediatric care in the urgent care setting, the best exchanges came from the discussions among the care providers. It was eye-opening to hear the staffing and physical environmental limitations that some smaller urgent cares are operating in that hampers their ability to manage moderate pediatric injuries and illness. We also were able to exchange 'tricks of the trade' in pediatric examination techniques, difficult conversations with caregivers, and obtain consensus around best-practices in pediatric testing and treatments for common illnesses.

UCA does a wonderful job representing the industry of urgent care, now supporting the Foundation of Urgent Care. This not-for-profit entity supports research efforts in the urgent care setting, including an annual benchmarking survey, clinical and practice management leadership, and education about innovation in this healthcare delivery model. They are also the only national urgent care association that has a full-time lobbyist on the Hill advocating on key issues affecting the patients seeking care in the urgent care setting.

As a health services researcher, I know that urgent care provides increased access to acute care for children. Making sure that children receive quality, evidence-based care is very important to me. I am a proud supporter of urgent care and appreciate the opportunity that UCA provides me to share my pediatric expertise with their membership.

*Amanda Montalbano, MD MPH FAAP (@MrsDrMonty) is the director of scholarly activities for the Division of Urgent Care and the Medical Director of Patient and Family Engagement for Children's Mercy Kansas City. She serves as the chair of research for both the Society of Pediatric Urgent Care and the Subcommittee on Urgent Care for the American Academy of Pediatrics. *

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