Paediatric Levels of Care

Last updated on September 1, 2022

Infants, children and youth have unique healthcare needs compared to adults; a range of paediatric expertise and resources is essential in hospitals to ensure that paediatric inpatients receive appropriate, safe and quality care throughout the continuum of inpatient care.

PCMCH developed three distinct paediatric levels of inpatient care that take into consideration the acuity of the presenting complaint; the medical complexity of the patient’s underlying condition; and/or the complexity of the surgery or procedure required. The goal is to ensure that quality services are provided to paediatric patients and their families as close to home as possible, in the right place, at the right time, and by the right provider(s).  Additionally, the levels will:

  • Help provide a clear, consistent, and transparent understanding of services provided at any given hospital site;
  • Enable healthcare professionals to know where to call for advice and consultation;
  • Support the flow of patients to both higher and lower levels of care, including repatriation;
  • Foster shared-care management of patients when appropriate;
  • Facilitate dialogue that identifies gaps and opportunities for capacity building, quality initiatives, system improvements, etc. at the organizational, regional and provincial levels; and
  • Enable a seamless system of care across the maternal-newborn-paediatric continuum.

Organizational Self-Assessment Survey

In October 2018, all Ontario hospitals were asked to complete an organizational self-assessment survey regarding mandatory and highly recommended criteria for the paediatric inpatient services they could provide within current resources. This process was not about increasing or decreasing capacity; rather, it was about standardization and acknowledging the services that hospitals are able to provide. A PLC designation was then assigned to hospitals in which inpatient care is provided to paediatric patients.

The PLC definitions and hospital designations, along with background information on the initiative, are available in the Paediatric Levels of Care Summary Report (June 2021).

Next Steps

The next phase is focused on implementing a regional system of care across Ontario that consists of a hub-and-spoke model across five PLC regions, with the hubs reflecting the paediatric expertise of centres in Hamilton, Kingston, London, Ottawa and Toronto that have a Level 3 PLC designation, as well as in some Level 2 PLC hospitals. This approach is intended to enhance access and expert care in geographically vast areas, often where limited expertise and resources are available, help facilitate patient flow and movement to the right level of care (higher and, in some instances, lower), and strengthens collaboration between healthcare providers/organizations.

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