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Learning lessons from the paediatric critical care response to the SARS-CoV-2 pandemic in England and Wales: a qualitative study.
Roche, Emma; Lim, Chun; Sayma, Meelad; Navaratnam, Annakan; Davis, Peter J; Ramnarayan, Padmanabhan; Fraser, James; Kenny, Simon.
  • Roche E; Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK emma.roche1@nhs.net.
  • Lim C; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Sayma M; Whittington Hospital NHS Trust, London, UK.
  • Navaratnam A; University College London Hospitals NHS Foundation Trust, London, UK.
  • Davis PJ; Bristol Royal Hospital for Children, Paediatric Intensive Care Unit, Bristol, UK.
  • Ramnarayan P; NHS England & NHS Improvement, London, UK.
  • Fraser J; Children's Acute Transport Service, London, UK.
  • Kenny S; Paediatric Critical Care Society, London, UK.
Arch Dis Child ; 107(3): e6, 2022 03.
Article in English | MEDLINE | ID: covidwho-1367406
ABSTRACT

OBJECTIVES:

To explore the experiences of clinical leads in paediatric critical care units (PCCUs) in England and Wales during the reorganisation of services in the initial surge of the SARS-CoV-2 pandemic and to learn lessons for future surges and service planning.

METHODS:

A qualitative study design using semistructured interviews via virtual conferencing was conducted with consultant clinical leads and lead nurses covering 21 PCCUs. Interviews were conducted over a period of 2 weeks, 2 months after the initial SARS-CoV-2 surge. Interview notes underwent thematic analysis.

RESULTS:

Thematic analysis revealed six themes leadership, management and planning; communication; workforce development and training; innovation; workforce experience; and infection prevention and control. Leadership was facilitated through clinician-led local autonomy for decision-making and services were better delivered when the workforce was empowered to be flexible in their response. Communication was preferred through collaborative management structures. Further lessons include recognising workforce competencies in surge preparations, the use of virtual technology in facilitating training and meetings, the importance of supporting the well-being of the workforce and the secondary consequences of personal protective equipment use.

CONCLUSIONS:

During the 2020 SARS-CoV-2 pandemic, an agile response to a rapidly changing situation was enabled through effective clinical leadership and an adaptive workforce. Open systems of communication across senior clinical and management teams facilitated service planning. Support for all members of the workforce through implementation of appropriate and innovative education and well-being solutions was vital in sustaining resilience. This learning supports planning for future surge capacity across paediatric critical care locally and nationally.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Care / Pandemics / COVID-19 / Hospital Planning / Intensive Care Units Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Child / Humans Country/Region as subject: Europa Language: English Journal: Arch Dis Child Year: 2022 Document Type: Article Affiliation country: Archdischild-2020-320662

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Care / Pandemics / COVID-19 / Hospital Planning / Intensive Care Units Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Child / Humans Country/Region as subject: Europa Language: English Journal: Arch Dis Child Year: 2022 Document Type: Article Affiliation country: Archdischild-2020-320662