Pediatric Complex Care Program FAQ

Pediatric Complex Care Program

Pediatric Complex Care Program FAQ

The Pediatric Complex Care Program at American Family Children's Hospital in Madison, Wisconsin, provides enhanced, coordinated care for children with complex medical problems that often involve multiple medical and surgical specialties.

What is the Pediatric Complex Care Program?

We are a medical team at American Family Children’s Hospital who are here to coordinate care for the most complex pediatric patients. We work with patients and families to improve care coordination and communication between all medical providers and the family. We will take part in your child’s care when hospitalized, in the clinic or at home.

What types of children are enrolled in the Pediatric Complex Care Program?

  • Kids that have problems in three or more body systems
  • Kids that are followed by at least three medical or surgical specialists
  • Kids that have frequent clinic visits and/or hospitalizations

How does my child become a part of the program?

We start with an enrollment. The enrollment visit is a clinic visit where we talk about your child’s medical history and current problems. This appointment can take about two hours.

About a week later we will call you to follow up on any outstanding issues. Using this info, we will create individualized care plans and crisis plans for your child, which we will send to you.

What happens after my child is a part of the program?

After your child is enrolled, we will provide ongoing care.

  • Regular follow up visits every three months: We will try to schedule appointments on days you are coming for other appointments.
  • Visits and consults when your child is in the hospital: We will communicate with the medical team caring for your child in the hospital to make sure ”nothing falls through the cracks.”
  • Phone or electronic communication with you to ensure that your child’s needs are being met.

Is there a time when my child will no longer be a part of the program?

Your child will graduate from the program at age 18, when your child’s medical issues are not as complex, or if you no longer feel our services are needed.

What do you ask of parents of children in the program?


  • Please arrive 20 minutes before your scheduled time to register
  • If you need to cancel an appointment, call as soon as possible and we can help you reschedule
  • If you are going to be more than 20 minutes late, we will do our best to see you, but we may need to reschedule


  • Much of our contact can be by phone or electronic, so please let us know if your phone number changes
  • Please use electronic messages through MyChart for issues that are not urgent
  • Phone calls and MyChart questions received during business hours (Monday through Friday, 8am-4:30pm) will be returned by the end of the business day
  • For urgent problems during normal business hours, please call (608) 263-6420 and ask that the nurse for Pediatric Complex Care be paged
  • For urgent problems during evenings or on weekends call (608) 263-6420 and ask for the doctor on call for Pediatric Complex Care. If you feel your child is having an emergency, please call 911 or go to the nearest emergency department