It is with great pleasure that we present the August 2020 issue of Hospital Pediatrics dedicated to the care of children with medical complexity, also known as complex care.

The past decade has been characterized by an increasingly detailed understanding of the impact of children with medical complexity on the inpatient setting. Children with complex chronic conditions account for ∼10% of US pediatric hospital admissions, ∼25% of pediatric hospital days, and ∼40% of pediatric hospital charges.1  Children with complex chronic conditions are increasing in prevalence over time as well as complexity.2  Children with complex chronic conditions experience wide variation in care3  (see the Supplemental Figure 1). The need to optimize evidence and identify best practices for this growing patient population is evident to many pediatric providers in inpatient and outpatient settings alike.

In recognition of the importance of complex care, the editorial board issued a call for manuscripts for this special issue starting in September 2019. It is an understatement to say we were excited and thrilled by the response we received; ∼25 paper submissions were completed by the end of March 2020. Equally impressive was the response of the complex care community to provide reviewer feedback for so many paper submissions. By my imperfect count, ∼70 individuals agreed to perform ≥1 review in April and May of 2020, a short time period that happened to coincide with the COVID-19 pandemic. The commitment demonstrated by the complex care community as a whole is truly inspired.

I hope you share my enthusiasm for this remarkable issue. We saw incredible variety in the manuscripts submitted, reflecting a dynamic emerging field. The original science articles in this issue run the gamut from clinical tools, including a differential diagnosis tool to aid with clinical assessment of pain in children with medical complexity,4  to development of an app to facilitate patient care for children with medical complexity.5  No issue dedicated to children with medical complexity would be complete without an exploration of current gaps in care, and our authors have provided original science on issues ranging from medical record documentation6  to discharge medication education7  and discharge communication practices,8  as well as feedback from home health care providers.9  We also received reports describing and evaluating care models for children with medical complexity,10,11  as well a health services research report.12  Included in this issue are valuable perspectives on a recent national initiative to improve care for children with medical complexity,13  as well as perspectives on the role of complex care in pediatric hospital medicine.14  Authors of additional perspective pieces suggest opportunities to improve care for children with medical complexity.15,16 

Given the robust interest in complex care and the tremendous response we received to the call for submissions, we are delighted to report that we plan to publish ≤2 complex care articles in each issue of Hospital Pediatrics. We eagerly await your original science submissions and are excited to watch how complex care providers and families will advance care for children with medical complexity in inpatient and outpatient settings in the next decade.

I thank the complex care community for their contributions.

Dr Simon conceptualized and designed the editorial, drafted the initial manuscript, and approved the final manuscript as submitted.

FUNDING: No external funding.

1
Simon
TD
,
Berry
J
,
Feudtner
C
, et al
.
Children with complex chronic conditions in inpatient hospital settings in the United States
.
Pediatrics
.
2010
;
126
(
4
):
647
655
2
Burns
KH
,
Casey
PH
,
Lyle
RE
,
Bird
TM
,
Fussell
JJ
,
Robbins
JM
.
Increasing prevalence of medically complex children in US hospitals
.
Pediatrics
.
2010
;
126
(
4
):
638
646
3
Ralston
SL
,
Harrison
W
,
Wasserman
J
,
Goodman
DC
.
Hospital variation in health care utilization by children with medical complexity
.
Pediatrics
.
2015
;
136
(
5
):
860
867
4
Morse
BL
,
Solodiuk
JC
,
Greco
CD
,
Mauskar
S
,
Hauer
J
.
Initial validation of GRASP: a differential diagnoses algorithm for children with medical complexity and an unknown source of pain
.
Hosp Pediatr
.
2020
;
10
(
8
):
633
640
5
Cheng
CF
,
Werner
NE
,
Doutcheva
N
, et al
.
Codesign and usability testing of a mobile application to support family-delivered enteral tube care
.
Hosp Pediatr
.
2020
;
10
(
8
):
641
650
6
Abebe
E
,
Scanlon
MC
,
Chen
H
,
Yu
D
.
Complexity of documentation needs for children with medical complexity: implications for hospital providers
.
Hosp Pediatr
.
2020
;
10
(
8
):
670
678
7
Gold
JM
,
Chadwick
W
,
Gustafson
M
,
Valenzuela Riveros
LF
,
Mello
A
,
Nasr
A
.
Parent perceptions and experiences regarding medication education at time of hospital discharge for children with medical complexity
.
Hosp Pediatr
.
2020
;
10
(
8
):
679
686
8
Rush
M
,
Herrera
N
,
Melwani
A
.
Discharge communication practices for children with medical complexity: a retrospective chart review
.
Hosp Pediatr
.
2020
;
10
(
8
):
651
656
9
Nageswaran
S
,
Sebesta
MR
,
Golden
SL
.
Transitioning children with medical complexity from hospital to home health care: implications for hospital-based clinicians
.
Hosp Pediatr
.
2020
;
10
(
8
):
657
662
10
Parker
CL
,
Wall
B
,
Tumin
D
, et al
.
Care coordination program for children with complex chronic conditions discharged from a rural tertiary-care academic medical center
.
Hosp Pediatr
.
2020
;
10
(
8
):
687
693
11
Murphy
NA
,
Alvey
J
,
Valentine
KJ
,
Mann
K
,
Wilkes
J
,
Clark
EB
.
Children with medical complexity: the 10-year experience of a single center
.
Hosp Pediatr
.
2020
;
10
(
8
):
702
708
12
Muesing
C
,
Schimelpfenig
B
,
Hustvet
D
,
Maynard
R
,
Christensen
EW
.
Longitudinal prevalence of tracheostomized children in Minnesota
.
Hosp Pediatr
.
2020
;
10
(
8
):
663
669
13
Conkol
KJ
,
Martinez-Strengel
A
,
Coller
RJ
,
Bergman
DA
,
Whelan
EM
.
Pediatric hospitalists’ lessons learned from an innovation award to improve care for children with medical complexity
.
Hosp Pediatr
.
2020
;
10
(
8
):
694
701
14
Ming
DY
,
Ehlenbach
ML
,
Falco
C
,
Coller
RJ
.
The intersection of complex care and hospital medicine: opportunities to advance health for chronically ill populations
.
Hosp Pediatr
.
2020
;
10
(
8
):
715
718
15
Quini
E
,
Kaushik
R
.
Is managed care better care? The effects of Medicaid managed care on children with medical complexity
.
Hosp Pediatr
.
2020
;
10
(
8
):
709
711
16
Kamzan
A
,
Jun-Ihn
E
,
Kulkarni
D
.
On the front lines of pediatric complex care: are we preparing emergency medicine residents?
Hosp Pediatr
.
2020
;
10
(
8
):
712
714

Competing Interests

POTENTIAL CONFLICT OF INTEREST: The author has indicated she has no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The author has indicated she has no financial relationships relevant to this article to disclose.

Supplementary data