COVID19: Reset Restore Recover

The International Paediatric Association published recommendations for all member paediatric societies to address children’s health and healthcare during the COVID-19 pandemic. It calls on all primary care and hospital resources for children and young people to be maintained during the crisis and ensure ongoing child and adolescent health concerns are prioritised.

A recent editorial by Crawley et al published in BMJ Paediatrics discussed the wider collateral damage to children in the UK as a result of the social distancing measures that have been introduced to reduce the impact of COVID-19 on the wider population. These include:

• Provisional reports of reduced vaccination rates.
• A decrease in paediatric emergency department visits.
• Increasing cases of delayed presentation of serious illness in children.
• Additional harm due to social isolation and its impact on mental health and well-being.
• Removal of protective school placements and confinement to home for the vulnerable.
• Changes across service provision from health, education and social care sectors.

The Health Foundation are currently running a series of virtual workshops focusing on rapid learning and improvement during COVID-19 here. As healthcare professionals look to restore services in the midst of an ongoing epidemic and prepare for the wider impact on children and young people, rapid deployment of new models of care have reset how we work within our systems and strengthened collaborative approaches towards greater integrated care.

A recent article by Coughlan et et al as part of the Quality Improvement series produced by the British Medical Journal in partnership with The Health Foundation outlined a framework for integrated care with an approach focussed around the patient perspective to enable improved coordination and continuity of care across organisational boundaries:

1. Building relationships – working across boundaries requires cultivation of a shared purpose between groups who would traditionally hold competing interests. 
2. Patient involvement – the patient perspective is central to integrated care and drives the momentum for co-designing for improvement.
3. Leadership – improvement across organisational boundaries requires dedicated leadership from all professional groups involved.

Similar themes were discussed in a webinar hosted by the International Society for Quality in Health Care with Dr Tejal Gandhi on safety and reliability during the COVID-19 crisis. High reliability principles and a culture of safety have equipped healthcare teams to deal with emergencies. A broader definition of harm to include ‘second victims’ now aims to address the psychological and emotional trauma of crisis as we start to recover the workforce too.