Pediatric capacity and capability gap analysis for surge planning

Background/Purpose:

History shows pandemics and disasters can disproportionately impact certain groups. In 2009, children ages 0-4 years old were hospitalized for Influenza H1N1 at a rate four times that of the adult population. Not all hospitals are equipped to meet the medical needs of children.  We hypothesized non-pediatric resources would need to be leveraged to handle a pediatric surge.

Methods:

After IRB approval, we conducted a gap analysis on pediatric hospital capacity and capability.  Eighty-three hospitals were surveyed using 38 questions focused on capacity, staffing, availability of pediatric supplies, and existing pediatric surge plans.  The survey was conducted between April 7 and July 15, 2011 using Qualitrics.

U.S. Census and publicly available bed capacity data were collected. Data were analyzed for capacity, pediatric designations and capabilities. Survey data were analyzed in Microsoft Excel by using frequency distributions, averages and medians for questions with numerical responses.  Open-ended responses were reviewed for emerging themes.

Results:

Overall survey response rate was 94% (78/83).  Seven high-level results were identfiied as gaps. These included limited pediatric acute and intensive care unit bed capacity, limited pediatric specialty physician resources, geographic variability, varying availability of pediatric trained staff, less availability of pediatric critical care supplies, and limited ability to admit children.

Conclusions:

We confirmed that our county would need to leverage non-pediatric hospitals, clinicians, and beds to accommodate a pediatric surge.  A plan has been developed to address hospital capacity for a surge disproportionately impacting children. We believe this plan could be enhanced by incorporating other agencies.