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Deployed: One Pediatric Department's Experience of Adult Care During COVID-19
Laura Nell Hodo1, Lindsey C Douglas2, Diana S Lee2
1Division of General Pediatrics, Department of Pediatrics, Icahn School of Medicine at Mount Sinai and Kravis Children's Hospital, New York, New York laura.hodo@mssm.edu.
Insights
Pediatricians deployed to adult care during COVID-19 experienced fear and discomfort, highlighting the need for better communication and preparation. Clearer deployment details and consistent communication can ease these concerns for healthcare professionals.
Area of Science:
- Medical Education and Training
- Public Health and Epidemiology
- Healthcare Administration
Background:
- The COVID-19 pandemic necessitated rapid reallocation of healthcare resources, including deploying pediatricians to adult care settings.
- Understanding the experiences and concerns of pediatric faculty during such deployments is crucial for optimizing staffing strategies during public health crises.
Purpose of the Study:
- To investigate the mindset, preparations, and experiences of pediatric faculty deployed to adult care during the initial COVID-19 surge.
- To identify areas for improvement in the deployment process for healthcare professionals in similar future scenarios.
Main Methods:
- Pre- and post-deployment surveys were administered to pediatric faculty, collecting data on perspectives, fears, and preparation strategies.
- Quantitative (Likert scale, multiple choice) and qualitative (free-text) responses were analyzed using descriptive statistics and comparative tests.
- Real-time feedback was provided to leadership to inform adjustments to the deployment process.
Main Results:
- A significant majority of deployed pediatric faculty (74%) reported discomfort with adult care, and 61% expressed fear or nervousness.
- While most faculty (88%) prepared for deployment, citing guidelines and literature, areas for improvement included schedule dissemination and role clarification.
- Survey responses were used to make real-time adjustments to the deployment process.
Conclusions:
- Pediatric faculty face significant concerns regarding deployment to adult care, encompassing both the process and the clinical work itself.
- Enhanced pre-deployment communication, including specific details about schedules and roles, alongside consistent messaging, is vital to mitigate faculty anxieties.
Objectives:
The number of hospitalized coronavirus disease 2019 patients in March 2020 to April 2020 in our New York City hospital required increased physician staffing, including deployment of pediatricians to adult care. To improve the deployment process, we sought to understand the mindset, preparations for, and experience during deployment of pediatric faculty in our institution.
Methods:
Faculty members of the Department of Pediatrics completed pre- and postsurveys evaluating perspectives, fears, and preparations relevant to deployment. Demographic characteristics of the faculty members were collected. Survey questions included Likert scale, multiple choice, and free-text responses. Descriptive statistics, Fisher's exact test, and χ2 test were used to compare groups. Free-text responses were categorized by topic. Survey responses were shared with leadership in real time and adjustments to the deployment process made.
Results:
The predeployment survey was sent to 202 pediatric faculty members, with a 29% (n = 59) completion rate. Of the 36 deployed faculty, 29 (81%) completed all items of the postsurvey. The majority (74%, n = 42) expressed discomfort with care of adults and fear and/or nervousness about deployment (61%, n = 35). Most faculty (88%, n = 52) prepared for deployment and cited local guidelines and published literature as helpful preparation materials (55%, n = 16). Dissemination of details about schedules and role clarification before deployment were areas for improvement.
Conclusions:
Pediatric faculty facing deployment to adult care have concerns about the process of deployment as well as the work itself. Specific information distributed in advance, along with consistent and frequent communication, may help mitigate these fears.
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