'Masks and Social Distancing -You Still Want to Add That Human Element': Impact of Covid-19 Changes on Children and Families

Background Despite lower rates of illness, morbidity and mortality associated with SARS-CoV-2 infection in children during the pandemic, their health and wellbeing has been significantly impacted. Emerging evidence indicates that this includes experiences of hospital-based care for them and their families. As part of a series of multi-site research studies to undertake a rapid appraisal of healthcare workers' perceptions of working during the pandemic, our study focussed on clinical and non-clinical staff perceptions of the impact of COVID-19 on aspects of care delivery, preparedness and staffing which were specific to a specialist children's hospital. Methods This was a qualitative study. Hospital staff were invited to take part in a single telephone interview. Researchers used a qualitative rapid appraisal design. This included a semi-structured interview guide, RREAL Rapid Assessment Procedure (RAP) sheet to share data, audio recording and transcription of interviews, with a framework approach to analysis. Results Thirty-six staff participated representing a wide range of roles within the hospital: 19 (53%) nurses, seven (19%) medical staff, 10 (28%) other staff groups (including radiographers, managers, play staff, schoolteachers, domestic and portering staff, social workers). Three themes related to the impact on children and families were identified: Same Hospital but Different for Everyone, Families Paid the Price and The Digital World. Conclusion Providing care and treatment for children and families changed profoundly during the pandemic, particularly during lockdowns periods. Adaptations to deliver clinical care, play, schooling, and other therapies online were rapidly put into action, however benefits were not universal or always inclusive. The disruption to a central principle of children's hospital care-the presence and involvement of families-was of critical concern to staff. We present perceptions of staff on how changes to the organisation of care delivery within Great Ormond Street Hospital impacted upon children and families.

'I Put That under My Work Blanket' - Children's Hospital Staff Experiences of Redeployment during the Covid-19 Pandemic

Background In March 2020 and January 2021 Great Ormond Street Hospital (GOSH) staff were redeployed to hospitals in North Central London, to support the care of adult Covid positive in-patients and paediatric services. In addition to providing care for children usually referred to GOSH, the hospital prepared for children who required hospital care who would usually have been admitted to other Paediatric Intensive Care Units across London - units repurposed to provide adult intensive care;and children who would normally receive their care in local hospital paediatric services, many of which were closed as staff were treating adults. Clinical skills training was offered to up-skill non-ward-based staff and provide an update on current techniques utilised in the care of general paediatric patients. Methods Within a wider study to understand healthcare workers' perceptions of care delivery in the context of the COVID-19 pandemic, GOSH staff were invited to take part in a single semi-structured interview by telephone. In our sampling strategy, we purposively recruited staff with experience of redeployment. We employed qualitative rapid appraisal design, RREAL Rapid Assessment Procedures (RAP) for early sharing, interpretation and analysis of data, audio recording and transcription of interviews and framework analysis. Results Recruitment and interviews took place between March and November 2021. Thirty-six GOSH staff were recruited, 18 (50%) participants had been redeployed outside the hospital and 4 (11%) within the hospital. We identified six themes which illustrated staff experiences of redeployment. These included (i) drivers and agency;(ii) preparation for redeployment;(iii) working reality;(iv) impact on family life;(v) professional disruption and (vi) personal challenges. Conclusion Redeployment was reported as both challenging and rewarding. More timely confirmation and bespoke training recognising individual skill sets was recommended. Support structures were available with the majority preferring those developed with close colleagues.

An interactive tool for enhancing hospital capacity predictions using an epidemiological model

Hospital managers have limited resources, and they have to plan on how best to allocate these resources based on predicted demand, which is often based on linear or exponential models. In this paper, we propose an interactive tool that produces a forecast of bed occupancy based on an epidemiological model. We optimise this model to fit recently observed data, and interactivity is conferred through a controllable parameter of the model such that users can readily investigate hypothetical scenarios for planning purposes. This study was designed with the Welsh National Health Service, and was born out of their practical need of accurately modelling hospital occupancy during the ongoing Covid-19 pandemic. © 2021 Owner/Author.