Children's Hospitals Caring for Adults During a Pandemic: Pragmatic Considerations and Approaches

Jenkins, Ashley; Ratner, Leah; Caldwell, Alicia; Sharma, Niraj; Uluer, Ahmet; White, Christine M.

doi:10.12788/jhm.3432

Cited by 21 publications

(26 citation statements)

References 10 publications

(11 reference statements)

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“…Suggested key strategies include involvement of multidisciplinary adult stakeholders in planning (e.g. pharmacy), adoption of adult protocols/order sets, safety huddles, safety event reporting, a system for adult care escalation, and access to adult hospitalist and sub-specialty consultation [ 8 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Children's Hospital Association published guidance on increasing adult capacity in general hospitals by consolidating pediatric care within specialized centers [6]. Hospital leaders also published editorials on general leadership principles, surge planning, and preparing clinicians to expand scope of practice [7][8][9]. However, these were not systematic studies, and they were limited to the experiences of large, academic centers and free-standing children's hospitals, where < 30% of children are cared for nationally [10].…”

Section: Introductionmentioning

confidence: 99%

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Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study

Penwill

Angulo

Pathak

et al. 2021

BMC Health Serv Res

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Background The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the United States, including changes in the care of hospitalized children. The objectives of this study were to identify major changes in healthcare delivery for hospitalized children during the COVID-19 pandemic, identify lessons learned from these changes, and compare and contrast the experiences of children’s and community hospitals. Methods We purposefully sampled participants from both community and children’s hospitals serving pediatric patients in the six U.S. states with the highest COVID-19 hospitalization rates at the onset of the pandemic. We recruited 2–3 participants from each hospital (mix of administrators, front-line physicians, nurses, and parents/caregivers) for semi-structured interviews. We analyzed interview data using constant comparative methods to identify major themes. Results We interviewed 30 participants from 12 hospitals. Participants described how leaders rapidly developed new hospital policies (e.g., directing use of personal protective equipment) and how this was facilitated by reviewing internal and external data frequently and engaging all relevant stakeholders. Hospital leaders optimized communication through regular, transparent, multi-modal, and bi-directional communication. Clinicians increased use of videoconference and telehealth to facilitate physical distancing, but these technologies may have disadvantaged non-English speakers. Due to declining volumes of hospitalized children and surges of adult patients, clinicians newly provided care for hospitalized adults. This was facilitated by developing care teams supported by adult hospitalists, multidisciplinary support via videoconference, and educational resources. Participants described how the pandemic negatively impacted clinicians’ mental health, and they stressed the importance of mental health resources and wellness activities/spaces. Conclusions We identified several major changes in inpatient pediatric care delivery during the COVID-19 pandemic, including the adoption of new hospital policies, video communication, staffing models, education strategies, and staff mental health supports. We outline important lessons learned, including strategies for successfully developing new policies, effectively communicating with staff, and supporting clinicians’ expanding scope of practice. Potentially important focus areas in pandemic recovery include assessing and supporting clinicians’ mental health and well-being, re-evaluating trainees’ skills/competencies, and adapting educational strategies as needed. These findings can help guide hospital leaders in supporting pandemic recovery and addressing future crises.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study

Penwill

Angulo

Pathak

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

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“…In addition to regionalization, children's hospitals may also face requests to accept adult patients or share equipment and/or staff with adult facilities; when these actions do not compromise the capacity of the pediatric institution to provide care to children, institutions should consider them. 12 However, pediatric institutions can best meet the duty of solidarity by expanding regional capacity through freeing up resources in general hospitals, including beds, ventilators, and staffing usable for adults, preventing all hospitals from needing to triage. If triage is necessary because the entire system has reached capacity, triage should also take place at children's hospitals, in respect of solidarity, to optimize this community resource.…”

Section: Crisis Standards Of Carementioning

confidence: 99%

Shifting Duties of Children's Hospitals During the COVID‐19 Pandemic

Paquette

Derrington

Fry

et al. 2020

Journal of Hospital Medicine

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“…However, the timing and severity of the anticipated COVID-19 hospitalization surge varies by geographic area, reflecting SARS-CoV-2 prevalence, local transmission, social distancing, and population density. Preparation, planning, coordinated communication, and sustained collaboration are essential to preserve healthcare capacity to meet community needs (Jenkins et al, 2020;Tanne et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Interprofessional/interdisciplinary teamwork during the early COVID-19 pandemic: experience from a children’s hospital within an academic health center

Natale

Boehmer

Blumberg

et al. 2020

Journal of Interprofessional Care

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The COVID-19 pandemic has created multiple, complex and intense demands on hospitals, including the need for surge planning in the many locations outside epicenters such as northern Italy or New York City. We here describe such surge planning in an Academic Health Center that encompasses a children's hospital. Interprofessional teams from every aspect of inpatient care and hospital operations worked to prepare for a COVID-19 surge. In so doing, they successfully innovated ways to integrate pediatric and adult care and maximize bed capacity. The success of this intense collaborative effort offers an opportunity for ongoing teamwork to enhance efficient, effective, and high-quality patient care.

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Children's Hospitals Caring for Adults During a Pandemic: Pragmatic Considerations and Approaches

Cited by 21 publications

References 10 publications

Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study

Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study

Shifting Duties of Children's Hospitals During the COVID‐19 Pandemic

Interprofessional/interdisciplinary teamwork during the early COVID-19 pandemic: experience from a children’s hospital within an academic health center

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