Stepwise Strategic Mitigation Planning in a Pediatric Oncology Center During the COVID-19 Pandemic

Abstract

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) first reached the United States in January 2020. Located in New York City (NYC), MSK Kids, at Memorial Sloan Kettering Cancer Center services, is one of the largest pediatric cancer centers in the U.S., caring for children, teenagers, and young adults with cancer, immune deficiencies, and blood disorders. Methods: Implementation for infection mitigation and ongoing care of patients included: (1) the creation of a strategic planning team of physicians, advanced practice providers, nurses, and administrators to develop guidance and workflows, (2) continuous reassessment of patients’ needs for hospital services and visit frequency, (3) the use of telemedicine to replace in-person visits, (4) the use of satellite regional centers to manage patients living outside NYC, (5) pre-screening of patients prior to visits for risks and symptoms of coronavirus disease 2019 (COVID-19) infection, (6) day-of-service screening for risks or symptoms of COVID-19 infection, (7) surveillance testing of children and their caregivers, and (8) creation of cohort plans for the management of COVID-19 positive and uninfected patients within the same institution, in both the outpatient and inpatient settings. Results: We describe the timeline for planning mitigation during the first weeks of the pandemic, and detail in a stepwise fashion the rationale and implementation of COVID-19 containment efforts in the context of a large pediatric oncology program. Discussion: Our experience offers a model on which to base strategic planning efforts at other pediatric oncology centers, for continued preparedness to combat the threat posed by SARS-CoV-2 worldwide.

Determination of the Quality of Life of Parents with Children Treated in the Pediatric Oncology Clinic during the COVID-19 Pandemic and Affecting Factors

“…12,13 Pediatric oncology nurses are of great importance in coordinating the child's care and identifying their needs. 2 However, the health of the child is closely related to the health of the caregivers as a result of the family-centered approach, which is the most important component of pediatric care. 14 Nurses should consider not only the child's but also the emotional and social needs of the family.…”

“…The public health measures necessary to reduce viral spread, pose a major threat to children with medical complexity, especially to pediatric oncology patients. 1,2 Childhood cancers are curable when correct diagnosis and appropriate treatment are provided on time. 3 Children with cancer often require long-term intensive chemotherapy.…”