Pediatric Alternate Site of Care During the 2009 H1N1 Pandemic

Chung, Sarita; Monteiro, Stephen; Hogencamp, Toni Clare; Damian, Frances J.; Stack, Anne M.

doi:10.1097/pec.0b013e31822255dd

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…Based on this experience, our facilities team felt that, similarly to the team from Boston Children’s Hospital in 2009, they would require a 24-hour window to establish and stock the ACS. 10 It was noted that while intuitive to MPERT staff, patients and families might find these new spaces confusing and that all the MPERT care spaces would require clear and multi-lingual signage to promote wayfinding. As an ACS for low-acuity patients, patient flow was an important factor when designing and testing the MPERT space.…”

Section: Discussionmentioning

confidence: 99%

Rapidly building surge capacity within a pandemic response using simulation-based clinical systems testing

Davis¹,

Doughty²,

Kerr³

et al. 2020

BMJ Simul Technol Enhanc Learn

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IntroductionAs the SARS-CoV-2 virus spread across the globe, hospitals around the USA began preparing for its arrival. Building on previous experience with alternative care sites (ACS) during surge events, Texas Children’s Hospital (TCH) opted to redeploy their mobile paediatric emergency response teams. Simulation-based clinical systems testing (SbCST) uses simulation to test preoccupancy spaces and new processes. We developed rapid SbCST with social distancing for our deployed ACS, with collaboration between emergency management, paediatric emergency medicine and the simulation team.MethodsA two-phased approach included an initial virtual tabletop activity followed by SbCST at each campus, conducted simultaneously in-person and virtually. These activities were completed while also respecting the need for social distancing amidst a pandemic response. Each activity’s discussion was facilitated using Promoting Excellence and Reflective Learning in Simulation (PEARLS) for systems integration debriefing methodology and was followed by compilation of a failure mode and effects analysis (FMEA), which was then disseminated to campus leaders.ResultsWithin a 2-week period, participants from 20 different departments identified 109 latent safety threats (LSTs) across the four activities, with 71 identified as being very high or high priority items. Very high and high priority threats were prioritised in mitigation efforts by hospital leadership.DiscussionSbCST can be rapidly implemented to hone pandemic responses and identify LSTs. We used SbCST to allow for virtual participation and social distancing within a rapidly accelerated timeline. With prioritised FMEA reporting, leadership was able to mitigate concerns surrounding the four Ss of surge capacity: staff, stuff, structure and systems.

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Section: Discussionmentioning

confidence: 99%

Rapidly building surge capacity within a pandemic response using simulation-based clinical systems testing

Davis¹,

Doughty²,

Kerr³

et al. 2020

BMJ Simul Technol Enhanc Learn

View full text Add to dashboard Cite

show abstract

“…Emergency departments have used a variety of ACSs to improve throughput. Examples include use of tents set up in parking lots, establishing medical trailers, use of offsite clinics, facility lobbies, and other hospital units as adjunct overflow care sites (Chung, Monteiro, Hogencamp, Damian, & Stack, 2011;Kelen, Scheulen, & Hill, 2001;Shin et al, 2012). Yet each of these ACS options has its drawbacks.…”

mentioning

confidence: 99%

Pediatric Patient Surge: Evaluation of an Alternate Care Site Quality Improvement Initiative

Leon

Enríquez

Rodriguez

et al. 2020

Journal of Trauma Nursing

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Background: Pediatric Level I trauma centers often experience patient volume surges. The increase stresses the emergency department, and usual patient care areas become inadequate. The purpose of this quality improvement study is to describe the implementation and analysis of an alternate care site to facilitate patient flow during seasonal patient volume surges. Methods: This initiative used a nonequivalent historical control group posttest-only design. An alternate care site was selected because of its size, temporary nature, low cost, and proximity to the emergency department. The alternate care site was activated between January and March 2019 using the following criteria: the total number of patients in waiting room 30 or more and wait times 2.5 hr or more. Outcome metrics include total census, length of stayadmissions, length of stay-discharges, left without being seen, hours per patient visit, patient satisfaction scores, and process metrics. Descriptive statistics and t tests were used to determine differences between groups.Results: A total of 180 patients were analyzed with n = 90 from 2018 and n = 90 from 2019. The alternate care site was activated five times over one season. The alternate care site decreased median waiting times, length of stayadmissions, length of stay-discharges, and left without being seen as compared with the previous year. Hours per patient visit and patient satisfaction scores remained constant as compared with the previous year. Conclusions: The creation of an alternate care site within the emergency department allowed quick mobilization, response, and treatment of patients. The alternate care site decreased median length of stay for admissions, discharges, and who left without being seen while keeping hours per patient visit and patient satisfaction constant. Future studies should confirm findings by testing the alternate care site in other hospitals and settings and should consider formally evaluating staff satisfaction.

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Pediatric emergency department volumes and throughput during the COVID-19 pandemic

Even

Lipshaw

Wilson

et al. 2021

The American Journal of Emergency Medicine

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Pediatric Alternate Site of Care During the 2009 H1N1 Pandemic

Abstract: Selected nonurgent patients with influenza-like illness during a pandemic can be treated in a safe and timely manner with high levels of family satisfaction in a novel setting.

Cited by 6 publications

References 10 publications

Rapidly building surge capacity within a pandemic response using simulation-based clinical systems testing

Rapidly building surge capacity within a pandemic response using simulation-based clinical systems testing

Pediatric Patient Surge: Evaluation of an Alternate Care Site Quality Improvement Initiative

Pediatric emergency department volumes and throughput during the COVID-19 pandemic

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