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Pediatric alternate site of care during the 2009 H1N1 pandemic
Sarita Chung1, Stephen Monteiro, Toni Hogencamp
1Division of Emergency Medicine, Children's Hospital Boston, Boston, MA 02115, USA. sarita.chung@childrens.harvard.edu
Insights
An alternate site of care (ASC) safely and efficiently treated nonurgent pediatric patients with influenza-like illness during the H1N1 pandemic, achieving high family satisfaction.
Area of Science:
- Public Health
- Pediatric Care
- Infectious Disease Management
Background:
- The 2009 H1N1 pandemic necessitated innovative healthcare delivery models.
- Alternate sites of care (ASC) were explored to manage patient surges.
- Pediatric patients with influenza-like illnesses (ILI) posed unique challenges.
Purpose of the Study:
- To detail the design and implementation of a novel ASC for pediatric ILI patients.
- To evaluate the performance of this ASC during the H1N1 pandemic.
- To assess patient throughput, safety, family satisfaction, and cost-effectiveness.
Main Methods:
- Described the physical setup and operational processes of the ASC.
- Collected data on patient demographics, length of stay, and transfer rates.
- Assessed safety through adverse event monitoring and family satisfaction surveys.
Main Results:
- The ASC operated for 7.5 days, treating 137 pediatric patients.
- Median patient age was 6.5 years; 5.8% required transfer to the ED.
- No adverse events occurred; 92% of families reported excellent or very good care.
Conclusions:
- A novel ASC setting is a safe and effective option for managing nonurgent pediatric ILI patients during pandemics.
- This model demonstrates timely care delivery and high family satisfaction.
- Successful implementation requires careful planning of site, staffing, and clinical protocols.
Objectives:
This study aimed to describe the design and implementation of an alternate site of care (ASC) for nonurgent pediatric patients with influenza-like illnesses during the 2009 H1N1 pandemic and to evaluate its performance.
Methods:
We describe the design and physical implementation of an ASC. Evaluation of the utilization, patient demographics, throughput, safety, family satisfaction, and cost are presented.
Results:
The process of project development, site selection, clinical algorithms, staffing supplies, and cost are detailed. The ASC was used for 7.5 days, and 137 patients were treated. The median age was 6.5 years. Forty-five percent were male, and English was the primary language. Median length of stay for patients evaluated was 65 minutes. Of patients, 5.8% were transferred from the ASC to the ED for further care. Also, 2.3% of patients returned to the ED within 72 hours; however, none required admission. There were no adverse events associated with the ASC and 92% of families rated overall care as very good or excellent.
Conclusions:
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.
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