Pediatric Hospital Medicine Management, Staffing, and Well-being in the Face of COVID-19

Our modern world is facing an unprecedented global health crisis caused by the rapid spread of a novel coronavirus that causes coronavirus disease 2019 (COVID-19), which was officially declared a pandemic by the World Health Organization (WHO) on March 11, 2020.¹ The Centers for Disease Control and Prevention (CDC) has urged US hospitals and healthcare systems to rapidly prepare for patient surges that risk overwhelming their resources.² Hospitalists are instrumental in coordinating the inpatient response. While this is a rapidly evolving situation, we will describe the initial logistical response of our academic pediatric Hospital Medicine division in terms of management, staffing, and wellness. Recognizing that early evidence from China described low inpatient pediatric disease burden,^3-5 our focus has centered on preparing to care for infected or potentially infected children, preserving staff and resources to ensure safe and effective care, and preparing to assist the adult response.

MANAGEMENT AND COMMUNICATION

Establish a Command Team

We benefit from having an existing divisional leadership structure comprising the director, medical directors of our clinical service lines, directors of education and community integration, and associate directors of clinical operations, research, and quality. This established team provides us broad representation of team member expertise and ideas. We maintain our weekly leadership team meeting through video chat and have added daily 30-minute virtual huddles to provide updates from our respective areas and discuss logistical challenges and planning. We use ad hoc phone meetings with relevant team members to address issues of immediate concern.

In the absence of a formal leadership team structure, establish a command team comprising representative leaders of your varied groups (eg, clinical operations, quality improvement, education, research, and business).