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Developing new models of care at speed: learning from healthcare redesign for children with COVID-related multisystem
C Ronny Cheung1,2, Anna Finnemore3, Jennifer Handforth2,4
1General Paediatrics, Evelina London Children's Hospital, London, UK ronny.cheung@gstt.nhs.uk.
Insights
Healthcare leaders rapidly reconfigured services for paediatric inflammatory multisystem syndrome (PIMS-TS), a novel COVID-19-associated condition. This article outlines transferable principles for managing emerging pediatric diseases and developing agile healthcare models.
Area of Science:
- Pediatric critical care
- Healthcare management
- Infectious disease epidemiology
Background:
- The emergence of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) presented unique challenges due to its novel nature.
- Understanding the natural history, clinical characteristics, and treatment options for PIMS-TS was initially limited, complicating care model development.
- The COVID-19 pandemic necessitated rapid adaptation of healthcare services to manage new and evolving clinical entities.
Purpose of the Study:
- To describe the system-wide reconfiguration of healthcare services in response to PIMS-TS.
- To analyze the redesign process using healthcare management science principles.
- To provide transferable recommendations for managing novel pediatric diseases and developing agile healthcare operating models.
Main Methods:
- Analysis of service reconfiguration through the lens of healthcare management science.
- Identification and outlining of key principles and recommendations for service adaptation.
- Review of challenges encountered in developing a care model for an emerging disease.
Main Results:
- Successful rapid, system-wide reconfiguration of local and network services was achieved.
- Transferable principles for managing novel pediatric conditions and developing new clinical services were identified.
- The study highlights the importance of agile and responsive healthcare models in the face of emerging health threats.
Conclusions:
- The principles outlined are relevant for pediatricians managing PIMS-TS and other emerging pediatric diseases.
- Healthcare leaders can utilize these recommendations to build flexible and responsive service models for unanticipated clinical entities.
- Proactive planning based on established management science can enhance healthcare system resilience during pandemics and emerging health crises.
Abstract:
This article describes the rapid, system-wide reconfiguration of local and network services in response to the newly described paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) (also known as multisystem inflammatory syndrome in children). Developing the model of care for this novel disease, whose natural history, characteristics and treatment options were still unclear, presented distinct challenges.We analyse this redesign through the lens of healthcare management science, and outline transferable principles which may be of specific and urgent relevance for paediatricians yet to experience the full impact of the COVID-19 pandemic; and more generally, for those developing a new clinical service or healthcare operating model to manage the sudden emergence of any unanticipated clinical entity. Health service leaders in areas where COVID-19 is, or will soon be, in the ascendancy, and who are anticipating the imminent influx of PIMS-TS, should use these principles and recommendations to plan an agile, responsive and system-wide model of care for these children.
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