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Simulation as a Dynamic Tool to Reorganize Pediatric Emergency Department Resuscitation During the Coronavirus

Megan E Lavoie1, Khoon-Yen Tay1, Grace Good2

  • 1From the Division of Emergency Medicine Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania.

Pediatric Emergency Care
|April 27, 2021
PubMed

Insights

Simulation rapidly improved pediatric emergency department workflows and safety during the COVID-19 pandemic. This approach minimized healthcare worker exposure while ensuring effective care for critically ill children requiring aerosol-generating procedures.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Management
  • Infectious Disease Preparedness

Background:

  • The COVID-19 pandemic necessitated rapid adaptations in pediatric emergency care to reduce healthcare worker (HCW) exposure to SARS-CoV-2.
  • Critical care for ill or injured children faced new challenges in minimizing viral transmission.

Purpose of the Study:

  • To develop and implement protocols minimizing HCW exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
  • To ensure safe and effective care for pediatric patients, especially those needing aerosol-generating procedures.

Main Methods:

  • Multidisciplinary systems and process simulation sessions were conducted in a pediatric emergency department (PED).
  • Evaluated and reorganized patient flow, communication strategies, and consultation processes.
  • Reinforced proper donning and use of personal protective equipment (PPE).

Main Results:

  • Simulation effectively disseminated new practices to PED staff.
  • Implemented workflow modifications included minimizing personnel in resuscitation rooms and establishing a "command post" for remote providers.
  • Adopted improved communication devices and PPE standards enhanced HCW safety.

Conclusions:

  • In situ systems and process simulation proved highly effective for adapting to the COVID-19 pandemic.
  • Simulation enabled agile restructuring of patient workflow and care for critically ill children in the PED.
  • This methodology is crucial for novel pandemic preparedness in pediatric emergency settings.
Abstract

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