Abstract Rationale Children with chronic and technology-dependent pulmonary conditions—such as chronic oxygen or ventilator dependence, tracheostomy, severe bronchopulmonary dysplasia (BPD), and neuromuscular respiratory disease—require complex, multidisciplinary outpatient management. Despite the critical importance of coordinated care, limited data exist regarding provider confidence and resource accessibility in this domain. This study aimed to identify gaps and opportunities in outpatient care coordination we for pediatric patients with complex pulmonary needs at a tertiary care institution. Methods We conducted a single site survey-based needs assessment across providers in pediatric pulmonary clinics, including nurses, nurse coordinators, and pulmonary and complex care physicians. The survey captured clinical setting, frequency of managing children with technology-dependence (home ventilation, tracheostomy, feeding tubes), confidence in accessing support services for underinsured families, perceived training needs, and open-ended reflections regarding care coordination on coordination successes and challenges. Results Respondents (n = 35) represented diverse roles and levels of experience, with many frequently managing children on home ventilators, airway clearance devices and/or feeding tubes. Confidence in arranging specialty follow-up was high; however, most respondents reported low confidence in securing home nursing and in-home therapies for uninsured families. Top areas where additional training was desired included state-specific non-Medicaid resources (70%), fundraising strategies (65%), and local nonprofit/community resources (60%). Open-ended responses highlighted system barriers, including limited nursing resources, inconsistent communication between care teams and external providers, and insurance/durable medical equipment (DME)-related obstacles. Providers noted that rural and uninsured children, socioeconomically disadvantaged families faced the greatest challenges. Reported facilitators of successful coordination included early social work involvement, proactive DME follow-up, and structured clinic workflows. Conclusions This multidisciplinary needs assessment identified substantial gaps in provider confidence and resources for coordinating care of children with complex pulmonary needs, particularly for uninsured/underinsured populations. Addressing these gaps through targeted training, EMR-based coordination tools, and stronger integration of social work support and care coordinator and implementing standardized, tracked outcome and process metrics may improve equity and outcomes for this vulnerable patient population. This abstract is funded by: None
Mcneill et al. (Fri,) studied this question.