Pediatric critical care capacity in Canada

Area of Science:

• Health Systems Research
• Pediatric Critical Care Medicine
• Epidemiology

Background:

• Pediatric intensive care unit (PICU) capacity is a critical health system challenge, especially during pandemics and winter surges.
• There is a significant lack of data on PICU capacity across Canada.

Purpose of the Study:

• To characterize the bed capacity of Canadian PICUs.
• To assess the ability of Canadian PICUs to accommodate surges in demand.

Main Methods:

• A cross-sectional survey was administered to all 19 Canadian PICUs.
• Data collected included funded/physical beds, unit characteristics, staffing, therapies, and surge management challenges.
• Quantitative data were summarized using counts and proportions; qualitative data were analyzed using inductive content analysis.

Main Results:

• All 19 Canadian PICUs responded, reporting 275 funded beds (217 level 3, 58 level 2) and 298 physical spaces.
• Canadian PICUs can add an average of 5.9 beds per unit during surges, totaling 108 temporary beds.
• Barriers to implementing surge plans were identified, indicating potential limitations in responding to increased demand.

Conclusions:

• Canadian PICU capacity is comparable to international benchmarks.
• The existing capacity may be insufficient to manage significant pediatric critical illness during a pandemic or epidemic.
• Further strategies are needed to enhance surge capacity and address identified barriers.