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

Authors
  • 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
Type
Published Article
Journal
The Journal of Pediatrics
Publisher
Elsevier Inc.
Publication Date
May 04, 2020
Volume
222
Pages
22–27
Identifiers
DOI: 10.1016/j.jpeds.2020.04.060
PMID: 32380026
PMCID: PMC7196893
Source
PubMed Central
Keywords
License
Unknown

Abstract

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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