Creating Pathways and Guidelines for Inpatient Pediatric Neuromuscular Admissions to Effectively Facilitate Multidisciplinary Care

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Patients with neuromuscular disorders have a variety of diagnoses, characterized by muscle weakness and atrophy. With medical advances and access to better technology, these patients are living longer and being admitted to the hospital for a variety of reasons. Due to their underlying pathologies, many body systems are affected. As these patients are more frequently admitted, it is important to ensure all their current medical needs are considered and met. Many children's hospitals have clinical pathways or guidelines to effectively manage and coordinate the multidisciplinary care for this patient population. Yet, HDVCH does not currently use a standardized order set or pathway for patients with neuromuscular disorders who are admitted to the hospital. This project explores how to better ensure patients suffering from neuromuscular disorders receive streamlined care while admitted.

To evaluate the current practices and care these patients received, our team distributed a survey to care team providers including; attending physicians, fellows, and advanced practice providers who currently work on primary hospitalist or pediatric critical care teams. Residents did not participate in this survey due to their limited total exposure to these services. The survey aimed to explore the current comfort of these teams caring for patients with neuromuscular disorders. It also evaluated interest in an order set/pathway and potential areas of improvement. Respondents to the survey were asked about their current experience admitting and caring for patients with neuromuscular disorders. They were also asked what items would be important to include in a pathway or order set for neuromuscular disorder patients.

The initial survey was predominantly filled out by attending physicians, who comprised 67% of respondents. The survey found that 61% of respondents reported treating approximately 1-5 patients with neuromuscular disorders in the past 12 months. Regarding multidisciplinary care, most respondents reported consulting pulmonology and neurology during these admissions. Supporting the need for a clear pathway/order set less than half reported routinely consulting palliative care. Ancillary care teams commonly consulted include respiratory therapy and nutrition services. However, child life and social work were less frequently reported to be contacted during admissions. Respondents to the survey felt that having an order set/pathway with recommended lab work would be beneficial to their workflow. Respondents were also interested in improving workflow when choosing respiratory support and airway clearance. Overall, 77% of respondents felt that having a pathway/order set to help guide admission courses would be useful.

This survey supports the creation of an order set for pediatric patients with neuromuscular disorders who are admitted to either the hospitalist or pediatric critical care services. Predominantly, providers reported interest in guidance for recommended lab work, respiratory support, and airway clearance. Our team hopes to use this data, as well as current pathways, to guide the creation of an order set/pathway for pediatric patients with neuromuscular disorders who are admitted to HDVCH, allowing for an effective and multidisciplinary approach to their care.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2117

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