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Caring for Sick Kids During a Pandemic: Why It’s Important and Ways to Do It Safely

As 2020 nears its end, the COVID-19 pandemic is still affecting communities across the country. Now that cold and flu season is here, too, children are experiencing a variety of respiratory symptoms and acute illnesses. In many areas, though, parents are feeling abandoned by their pediatricians because they are being sent to urgent care and emergency departments.

While referrals are sometimes appropriate for acute pediatric illnesses, patients are more likely to fall through the cracks if they are seen by several different providers and lack continuity of care. Families who go outside the medical home are also at risk for increased exposure to other illnesses and higher out-of-pocket costs. In addition, unnecessary referrals may place an unfair burden on the urgent care system as sicknesses surge.

We all have to creatively figure out how to get patients and families connected to the right care at the right place at the right time. Pediatricians must be prepared to safely treat sick children, rather than give in to fear. Here are four ways to provide patient-centered care during the pandemic.

Continue General Pandemic Practices

For both sick and well care, social distancing, universal mask-wearing, and hand washing are essential. Have a mask-wearing policy that is consistent with the AAP’s guidance and communicate these protocols to families. 

Wear appropriate PPE and regularly review how to don and remove it. This improves confidence among your team members and demonstrates a safe environment for patients and families.

In addition to strict disinfecting and cleaning procedures, keep your facility safe by eliminating your waiting room, and having patients wait in their vehicles. Another option is to provide alternate waiting and care delivery sites.

Up Your Communication Game

Having excellent communication between your practice and the families you serve is one of the most important ways to keep people safe. For example, screen patients before seeing them in your office and explain why you’re doing it. This helps the patient, but it also protects the staff from patients who may not want to admit they have COVID symptoms.

Be clear about your expectations for in-office visits. In addition to social distancing and mask-wearing protocols, let families know that only one caregiver is allowed to accompany a sick child. Explain possibilities like a parking lot visit, where the sick child stays in the car, or an escort from the car directly to an exam room.

Don’t forget to use your website and social media accounts to connect with families! Digital communication is an easy way to convey information, and it allows you to relate to patients and their caregivers during a time when relationships are especially important.

Use Telemedicine When Appropriate

A powerful alternative to in-person care, telehealth can be used to provide acute care, enhanced triage, patient and family education, and close follow-up. Yes, you are limited in some physical examination elements, but view telemedicine as a way to safely evaluate many patients who have an acute illness or injury and then escalate them to the most appropriate place for in-person care if needed.

Keep in mind: Telemedicine is not a substitute for in-person care when a detailed physical examination or intervention is necessary. If the patient needs further assessment or office-based treatment, turn a virtual visit into an in-person one. This strategy keeps patients in the medical home and can help your practice prioritize necessary office visits.

Rearrange Your Workflow As Necessary

As you aim to provide access to in-person acute care, you may need to redesign workflow. For example, replace self-scheduling for sick appointments with nurse triage conversations. Instead of walk-in hours for acute visits, offer walk-in virtual visits.

Update your triage processes for when patients call with acute care needs. This might mean giving advice for home care, using telemedicine, scheduling an in-person visit, or referring to a good partner in the medical neighborhood.

Depending on the physical space you have in your office, try to separate sick and well patients. When possible, assign separate providers to sick and well care. Another option is to offer well care in the mornings and sick care in the afternoons. 

What we do know is that we must be flexible and adjust our workflows as demand/needs change. In addition, patients want to know that their medical home is there for them, is working hard to give safe care and that together the community can navigate this difficult time together.

Sue Kressly
kiddrsue@gmail.com


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