Pediatric Pathways

Pediatric Complex Care Program Launched

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Dr. Mary Ehlenbach is the Pediatric Complex Care Program medical director.As more children with complex medical needs are living longer and more productive lives, caring for these patients deserves increasingly greater attention from leading children’s hospitals. To address this need, UW Health’s American Family Children’s Hospital in Madison has just launched its own Pediatric Complex Care Program.

“Children with medical complexity are relatively small in number, but they are frequent consumers of the healthcare system,” says Mary Ehlenbach, MD, medical director of the Pediatric Complex Care Program at the American Family Children’s Hospital. “Our goal is to provide patients and families with highly-coordinated care with a global perspective in mind, and to help patients and families navigate the healthcare system, which can be very confusing when kids are seen by multiple specialists.”

This approach, says Dr. Ehlenbach, can be especially helpful not only for families, but also for primary care or referring physicians who seek a contact person at the Children’s Hospital who can help with coordinating all of a medically complex child’s care. Enhanced coordination, says Dr. Ehlenbach, should also help decrease the child’s frequency and length of hospitalizations and/or Emergency Department visits.

Patients who qualify for the new program will:

  • Have three or more affected organ systems
  • See four or more pediatric specialists
  • Have been recently hospitalized or seen in the Emergency Department.

Patients whose care is coordinated through existing disease-specific programs will not be enrolled.

“This program will focus on children with medical complexity who are followed by many specialists at the children’s hospital, but do not have a specific group overall in charge of their care,” says Dr. Ehlenbach. “Typically, children managed by complex care programs around the country may have been born prematurely, have genetic abnormalities or have survived a long stay in the Pediatric Intensive Care Unit.”

For the family’s convenience, clinic appointments often will be scheduled in conjunction with the child’s other pediatric specialty clinic visits. In addition to Dr. Ehlenbach, the Pediatric Complex Care Team consists of

Dr. Coller, who came to Madison in 2013, previously served as medical director of the Pediatric Medical Home Program at Mattel Children’s Hospital UCLA.