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RESULTS:We interviewed 9 managers and 15 physician leads from 13 Canadian PICUs. We identified 6 main themes.(1) Operationalizing the policies required enhancement and adaptation of usual leadership roles while (2) working in the middle of organizational hierarchy. (3) The RFP policies made explicit the need to balance stakeholder safety with compassion in caring for the sickest children. (4) Most PICU leaders perceived unintended effects of the RFP policies as having a negative impact on families, healthcare providers, and family centered care. (5) Implementing, communicating, and enforcing restrictions took personal tolls on many of the leaders. ( 6) Leaders recognized multiple opportunities for policy improvements.CONCLUSIONS: RFP policies had significant professional and personal impacts on PICU leaders, who identified both unintended consequences of and future opportunities for restricted presence policies.

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Infectious complications during ECLS are very common, and ECLS duration is significantly longer in patients with infections. Measures should be put in place to prevent infectious complications and reduce time on ECLS.