COVID19: QI From the Frontline 22nd April, 2020

The Paediatrics Hub

Paediatric COVID-19 hubs have allowed regions to check staffing levels on a daily basis across the local medical, nursing and allied health professionals workforce. Acute hospital Trusts are also collaborating with their community nursing teams to deliver care out of hospital and to build staffing capability and capacity across paediatrics at a regional level.

The hubs also oversee local reconfiguration activity through a number of ways:

1. Linking weekly or more with adult intensive care units and radiology teams to receive up-to-date information on the wider service pressures and enable coordinated surge planning.
2. Ensure anaesthetic support with paediatric expertise is provided for paediatric high-dependency and intensive care units that are caring for COVID-19 patients.
3. Consolidating paediatric emergency care to allow ambulances to bring direct to services and maintaining designated major trauma and resuscitation care for children and young people in Emergency Departments that require increased capacity for adult patients.
4. Creation of red and green zones across different ward areas to keep COVID-19 positive and suspected COVID-19 patients separate from at-risk unimmunised children and the immunosuppressed.
5. Moving critical outpatients services to a separate site on the hospital grounds and conducting telephone consultations from home. Local IT teams have made it possible for consultant paediatricians to use home computers and securely access necessary systems.
6. Setting up a main telephone advice line facilitated by paediatric medical secretaries who forward queries to one or two consultants and avoid overburdening the frontline staff on acute inpatient wards. Specific issues that cannot be resolved are then triaged to the appropriate person with the relevant specialism and expertise.
7. Rota changes have created a relief model with multiple tiers of decision-makers identified before additional staff are called on. This ensures colleagues have protected rest time and builds up team resilience for the future.

The Integrated Care Hub

Connecting Care Children’s Hubs (CCCHs) across Hampshire, England were originally introduced as a collaborative initiative as part of the ‘Healthier Together Programme’. This was developed in partnership with parents and healthcare professionals from across Dorset, Hampshire and the Isle of Wight, with the aim of improving the quality of care for children and young people across Wessex.

Its Healthier Together website provides public facing information and safety netting information on common presentations to provide parents and carers with accurate, reliable healthcare information for their child in one easily accessible place. It is also used by healthcare professionals with clear guidance and standardised clinical pathways to reduce variations in care across the region.