Pediatric facilities, during #COVID19 pandemic & beyond, may have an ongoing role to play in consolidating & coordinating care in ways that optimize health system capacity for both adults and children.

Learn more in our @JHospitalMed article https://www.journalofhospitalmedicine.com/jhospmed/article/220705/hospital-medicine/childrens-hospitals-caring-adults-during-pandemic

Has your pediatric hospital or facility considered if they might be able to help absorb a surge of hospitalized adult patients during the #COVID19 pandemic?

My co-authors @RatnerLeah @AliciaKramer11 @NirajmdSharma Ahmet Uluer Christy White and I have experience caring for specific adult populations @cincychildrens @bostonchildrens. Our learnings may apply.

First foremost, any pediatric facility considering expanding care to incl adults must first evaluate if they have the capacity to do so. Developing a multi-stakeholder team is the only way to adequately assess such capacity.

Responding to a crisis still necessitates establishing a clear care-escalation plan. This may be more challenging for systems depending on ICU bed availability and access to adult-trained intensivists.

What is a pediatrician’s scope of practice? While state and institutional policies lay the foundation for pediatric systems considering new adult-care models, provider-level considerations are also needed (eg provider comfort and ability).

There are many ways, even during a crisis, to develop an adult care model in a pediatric setting to support pediatricians. Depending on workforce availability, IM, Med-Peds, fam medicine, critical care, and emergency med physicians could serve as a primary service or consultants.

Adults are more likely than children to have comorbidities and clinical deterioration while hospitalized. Who has ACLS training? How are the code carts stocked? How can you get someone to the cath lab for a heart attack?

Finally, while tempting to address 1st, determining patient criteria may come last if/when developing new adult care models during #COVID19 pandemic. So much is dependent on what your hospital or system has/does not have in place already to support this care.

Our adult-care models required building relationships between pediatric and adult health systems. Building these relationships in the setting of crisis can strengthen health systems and healthcare communities beyond the era of #COVID19

Because it’s promoted enhanced collaboration between pediatric and adult facilities, #COVID19 can be a platform to build a better system to support our already vulnerable young adults with chronic conditions of childhood origin for years to come. @popcornetwork @GotTransition2