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Rapid Implementation of an Adult Coronavirus Disease 2019 Unit in a Children's Hospital

  • Philips, Kaitlyn1, 2
  • Uong, Audrey1, 2
  • Buckenmyer, Tara3
  • Cabana, Michael D.1, 2
  • Hsu, Daphne1, 2
  • Katyal, Chhavi1, 2
  • O'Connor, Katherine1, 2
  • Shiminski-Maher, Tania3
  • Hametz, Patricia1, 2
  • 1 Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY
  • 2 Albert Einstein College of Medicine, Bronx, NY
  • 3 Department of Nursing, Children's Hospital at Montefiore, Bronx, NY
Published Article
The Journal of Pediatrics
Elsevier Inc.
Publication Date
May 04, 2020
DOI: 10.1016/j.jpeds.2020.04.060
PMID: 32380026
PMCID: PMC7196893
PubMed Central


Objective To describe the rapid implementation of an adult coronavirus disease 2019 (COVID-19) unit using pediatric physician and nurse providers in a children's hospital and to examine the characteristics and outcomes of the first 100 adult patients admitted. Study design We describe our approach to surge-in-place at a children's hospital to meet the local demands of the COVID-19 pandemic. Instead of redeploying pediatric providers to work with internist-led teams throughout a medical center, pediatric physicians and nurses organized and staffed a 40-bed adult COVID-19 treatment unit within a children's hospital. We adapted internal medicine protocols, developed screening criteria to select appropriate patients for admission, and reorganized staffing and equipment to accommodate adult patients with COVID-19. We used patient counts and descriptive statistics to report sociodemographic, system, and clinical outcomes. Results The median patient age was 46 years; 69% were male. On admission, 78 (78%) required oxygen supplementation. During hospitalization, 13 (13%) eventually were intubated. Of the first 100 patients, 14 are still admitted to a medical unit, 6 are in the intensive care unit, 74 have been discharged, 4 died after transfer to the intensive care unit, and 2 died on the unit. The median length of stay for discharged or deceased patients was 4 days (IQR 2, 7). Conclusions Our pediatric team screened, admitted, and cared for hospitalized adults by leveraging the familiarity of our system, adaptability of our staff, and high-quality infrastructure. This experience may be informative for other healthcare systems that will be redeploying pediatric providers and nurses to address a regional COVID-19 surge elsewhere.

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