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J Pediatr. Rapid Implementation of an Adult COVID-19 Unit in a Children's Hospital

tetano

Editor, Senior Moderator
J Pediatr. 2020 Apr 28. pii: S0022-3476(20)30564-3. doi: 10.1016/j.jpeds.2020.04.060. [Epub ahead of print]
Rapid Implementation of an Adult COVID-19 Unit in a Children's Hospital.


Philips K[SUP]1[/SUP], Uong A[SUP]2[/SUP], Buckenmyer T[SUP]3[/SUP], Cabana MD[SUP]2[/SUP], Hsu D[SUP]2[/SUP], Katyal C[SUP]2[/SUP], O'Connor K[SUP]2[/SUP], Shiminski-Maher T[SUP]3[/SUP], Hametz P[SUP]2[/SUP].

Author information




Abstract

OBJECTIVE:

To describe the rapid implementation of an adult coronavirus disease 2019 (COVID-19) unit using pediatric physician and nurse providers in a children's hospital and to examine the characteristics and outcomes of the first 100 adult patients admitted.
STUDY DESIGN:

We describe our approach to surge-in-place at a children's hospital to meet the local demands of the COVID-19 pandemic. Instead of re-deploying pediatric providers to work with internist-led teams throughout a medical center, pediatric physicians and nurses organized and staffed a 40-bed adult COVID-19 treatment unit within a children's hospital. We adapted internal medicine protocols, developed screening criteria to select appropriate patients for admission, and reorganized staffing and equipment to accommodate adult COVID-19 patients. We used patient counts and descriptive statistics to report sociodemographic, system, and clinical outcomes.
RESULTS:

The median patient age was 46 years; 69% were male. On admission, 78 (78%) required oxygen supplementation. During hospitalization, 13 (13%) eventually were intubated. Of the first 100 patients, 14 are still admitted to a medical unit, 6 are in the intensive care unit, 74 have been discharged, 4 died after transfer to the ICU, and 2 died on the unit. The median length of stay for discharged or deceased patients was 4 days (IQR 2,7).
CONCLUSIONS:

Our pediatric team screened, admitted, and cared for hospitalized adults by leveraging the familiarity of our system, adaptability of our staff, and high-quality infrastructure. This experience may be informative for other healthcare systems that will be re-deploying pediatric providers and nurses to address a regional COVID-19 surge elsewhere.
Copyright ? 2020. Published by Elsevier Inc.



KEYWORDS:

adult management; coronavirus; hospitalization; pediatrics; surge capacity


PMID:32380026DOI:10.1016/j.jpeds.2020.04.060
 
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