Integrated clinical co-management is the ideal starting place and epitomizes the overall goal of improved care and outcomes.

There is a need to first link the clinical management before embarking upon research collaboration. First stages involve defining existing immunosuppressive/infectious protocols in each discipline and revising those and coordinating with infectious diseases as well as the other groups. We need to define the best available practices and standardize their use across the institution.

A dedicated parallel service for Pediatric Transplant Infectious Diseases has been established, with dedicated faculty focusing on these severely immunocompromised patients. This service, a critical clinical arm of the DPIHP, enables patients to receive coordinated care around their immunosuppression and underlying diseases.   

We have regularly scheduled meetings of all interested clinicians to discuss opportunities for coordination and also discuss individual patient cases. DPIHP can also integrate with pediatric antimicrobial stewardship and pediatric infection control for optimal care.

Key Points

  • Facilitate improved co-management to integrate clinical care for pediatric immunocompromised patients
    • New multi-disciplinary conferences to improve communication and highlight care issues, strategies, and opportunities
    • Dedicated pediatric transplant ID co-rounding on inpatient transplant services and outpatient support embedded in transplant organ clinics
    • Optimizing joint pediatric protocols/pathways for infections and immunizations
    • Establishing a monthly pediatric SOT quality and M&M meeting
  • Programmatic involvement
    • Development of pediatric-specific protocols, best practices, and quality improvement initiatives spanning all organs