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Published on: September 24, 2020
Up to the Challenge: Adapting Pediatric Intensive Care During a Global Pandemic
Myra Pereira1, Olugbenga Akinkugbe1, Laura Buckley1,2,3
1Department of Critical Care Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
Insights
Pediatric Intensive Care Unit teams adapted to care for adult COVID-19 patients, providing essential support and experiencing personal growth. Family members appreciated the compassionate, individualized care during a challenging pandemic period.
Area of Science:
- Healthcare Systems
- Critical Care Medicine
- Pandemic Response
Background:
- The COVID-19 pandemic severely impacted global health systems, necessitating rapid adaptations in care delivery.
- Surging numbers of critically ill adult patients required immediate, system-wide responses.
- A Pediatric Intensive Care Unit (PICU) repurposed resources to care for adult patients during the pandemic peak.
Purpose of the Study:
- To describe the experiences and impacts of a rapidly implemented Adult COVID-19 Program on healthcare providers (HCP) and family members.
- To identify lessons learned from this unique care delivery model using Havelock's Theory of Change.
Main Methods:
- A quality improvement review collected feedback from the healthcare team and patient families.
- Healthcare providers completed a questionnaire 10 months post-implementation.
- Family member feedback was gathered during the program, analyzed using Havelock's Theory of Change.
Main Results:
- Healthcare providers reported motivation, readiness, initial safety concerns, and the importance of support and collaboration.
- An overarching theme of 'doing our part to help' emerged among HCP.
- Family members highlighted positive impacts of family-centered care, individualized attention, and expressed shock at their loved ones' critical illness.
Conclusions:
- The PICU team successfully adapted to provide critical care for adult COVID-19 patients.
- Family members expressed gratitude for the care received in a pediatric setting.
- Caring for adult COVID-19 patients offered the PICU team a source of tension, personal growth, and meaning.
Background:
The COVID-19 pandemic has strained health systems world wide. In our region, surging numbers of critically ill adult patients demanded urgent system-wide responses. During the peak of the pandemic, our Pediatric Intensive Care Unit (PICU) team redesigned the existing educational resources and processes of care to ensure for adult patients for the first time in the hospital's history.
Aim:
Describe the experiences and impacts of the rapidly initiated Adult COVID-19 Program on health care providers (HCP) and family members. Havelock's Theory of Change framed the examination of Adult COVID-19 Program participant experiences and surfaced lessons learned.
Materials And Methods:
A quality improvement review was employed to collect feedback about the program experience from the health care team and patient's family members. HCP completed a questionnaire 10 months following the implementation of the program and feedback from family members was provided during the program was obtained. Havelock's Theory of Change was used to explore trends and frame participants' experiences.
Results:
Pediatric Intensive Care Unit bedside team members and clinical leaders (n = 17), adult hospital partners (n = 3), and family members (n = 8) participated. HCP describe; motivation and readiness; concern for personal safety and uncertainty experienced in the early program phases; the importance of supports and resources; use of relationships and collaboration to facilitate change; the emotional impacts of this unique experience; and opportunities for individual and team growth. An overarching theme of 'doing our part to help' emerged. Family members described the positive impacts of family-centered interventions offered, individualized care, and shock at their family member's illness.
Conclusion:
The PICU team rapidly adapted to provide care for adults at the peak of the pandemic. Family members expressed feeling grateful for the care their loved ones received in the pediatric setting. The experience of caring for adult patients with COVID-19 was a source of tension, personal growth, and meaning for the pediatric intensive care team.
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