Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: A cross-sectional survey study

Katy Rose; Silvia Bressan; Kate Honeyford; Zsolt Bognar; Danilo Buonsenso; Liviana Da Dalt; Tisham De; Ruth Farrugia; Niccolo Parri; Rianne Oostenbrink; Ian Maconochie; Henriette A. Moll; Damian Roland; Luigi Titomanlio; Ruud Nijman

doi:10.1136/bmjpo-2021-001269

Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: A cross-sectional survey study

Katy Rose^*, Silvia Bressan, Kate Honeyford, Zsolt Bognar, Danilo Buonsenso, Liviana Da Dalt, Tisham De, Ruth Farrugia, Niccolo Parri, Rianne Oostenbrink, Ian Maconochie, Henriette A. Moll, Damian Roland, Luigi Titomanlio, Ruud Nijman

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Objective Understanding how paediatric emergency departments (PEDs) across Europe adapted their healthcare pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave.

Design This cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured (1) study site characteristics, (2) departmental changes and (3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January-May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared with peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres.

Results Overall, 97% (n=38) of centres remained open as usual during the pandemic. The capacity of 18 out of 28 (68%) short-stay units decreased; in contrast, 2 units (7%) increased their capacity. In 12 (31%) PEDs, they reported acting as receiving centres for diverted children during the pandemic. There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs. There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8% of possible changes and standalone paediatric centres made 6% of possible changes (p=0.086).

Conclusion Overall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic.

Original language	English
Article number	e001269
Journal	BMJ Paediatrics Open
Volume	5
Issue number	1
DOIs	https://doi.org/10.1136/bmjpo-2021-001269
Publication status	Published - 20 Dec 2021

Bibliographical note

Funding Information:
Funding KR is funded by the University College London NHS Foundation Trust as part of a Senior Clinical Fellowship role, RN is funded for his research via NIHR ACL award (CL-2018-21-007). Imperial College London is the main research sponsor of this study.

Publisher Copyright:
©

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Rose, K., Bressan, S., Honeyford, K., Bognar, Z., Buonsenso, D., Da Dalt, L., De, T., Farrugia, R., Parri, N., Oostenbrink, R., Maconochie, I., Moll, H. A., Roland, D., Titomanlio, L., & Nijman, R. (2021). Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: A cross-sectional survey study. BMJ Paediatrics Open, 5(1), Article e001269. https://doi.org/10.1136/bmjpo-2021-001269

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title = "Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: A cross-sectional survey study",

abstract = "Objective Understanding how paediatric emergency departments (PEDs) across Europe adapted their healthcare pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave. Design This cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured (1) study site characteristics, (2) departmental changes and (3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January-May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared with peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres. Results Overall, 97\% (n=38) of centres remained open as usual during the pandemic. The capacity of 18 out of 28 (68\%) short-stay units decreased; in contrast, 2 units (7\%) increased their capacity. In 12 (31\%) PEDs, they reported acting as receiving centres for diverted children during the pandemic. There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs. There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8\% of possible changes and standalone paediatric centres made 6\% of possible changes (p=0.086). Conclusion Overall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic. ",

author = "Katy Rose and Silvia Bressan and Kate Honeyford and Zsolt Bognar and Danilo Buonsenso and \{Da Dalt\}, Liviana and Tisham De and Ruth Farrugia and Niccolo Parri and Rianne Oostenbrink and Ian Maconochie and Moll, \{Henriette A.\} and Damian Roland and Luigi Titomanlio and Ruud Nijman",

note = "Funding Information: Funding KR is funded by the University College London NHS Foundation Trust as part of a Senior Clinical Fellowship role, RN is funded for his research via NIHR ACL award (CL-2018-21-007). Imperial College London is the main research sponsor of this study. Publisher Copyright: {\textcopyright} ",

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month = dec,

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Rose, K, Bressan, S, Honeyford, K, Bognar, Z, Buonsenso, D, Da Dalt, L, De, T, Farrugia, R, Parri, N, Oostenbrink, R, Maconochie, I, Moll, HA, Roland, D, Titomanlio, L & Nijman, R 2021, 'Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: A cross-sectional survey study', BMJ Paediatrics Open, vol. 5, no. 1, e001269. https://doi.org/10.1136/bmjpo-2021-001269

TY - JOUR

T1 - Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe

T2 - A cross-sectional survey study

AU - Rose, Katy

AU - Bressan, Silvia

AU - Honeyford, Kate

AU - Bognar, Zsolt

AU - Buonsenso, Danilo

AU - Da Dalt, Liviana

AU - De, Tisham

AU - Farrugia, Ruth

AU - Parri, Niccolo

AU - Oostenbrink, Rianne

AU - Maconochie, Ian

AU - Moll, Henriette A.

AU - Roland, Damian

AU - Titomanlio, Luigi

AU - Nijman, Ruud

N1 - Funding Information: Funding KR is funded by the University College London NHS Foundation Trust as part of a Senior Clinical Fellowship role, RN is funded for his research via NIHR ACL award (CL-2018-21-007). Imperial College London is the main research sponsor of this study. Publisher Copyright: ©

PY - 2021/12/20

Y1 - 2021/12/20

N2 - Objective Understanding how paediatric emergency departments (PEDs) across Europe adapted their healthcare pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave. Design This cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured (1) study site characteristics, (2) departmental changes and (3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January-May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared with peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres. Results Overall, 97% (n=38) of centres remained open as usual during the pandemic. The capacity of 18 out of 28 (68%) short-stay units decreased; in contrast, 2 units (7%) increased their capacity. In 12 (31%) PEDs, they reported acting as receiving centres for diverted children during the pandemic. There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs. There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8% of possible changes and standalone paediatric centres made 6% of possible changes (p=0.086). Conclusion Overall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic.

AB - Objective Understanding how paediatric emergency departments (PEDs) across Europe adapted their healthcare pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave. Design This cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured (1) study site characteristics, (2) departmental changes and (3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January-May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared with peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres. Results Overall, 97% (n=38) of centres remained open as usual during the pandemic. The capacity of 18 out of 28 (68%) short-stay units decreased; in contrast, 2 units (7%) increased their capacity. In 12 (31%) PEDs, they reported acting as receiving centres for diverted children during the pandemic. There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs. There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8% of possible changes and standalone paediatric centres made 6% of possible changes (p=0.086). Conclusion Overall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic.

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U2 - 10.1136/bmjpo-2021-001269

DO - 10.1136/bmjpo-2021-001269

M3 - Article

C2 - 35413003

AN - SCOPUS:85122252196

SN - 2399-9772

VL - 5

JO - BMJ Paediatrics Open

JF - BMJ Paediatrics Open

IS - 1

M1 - e001269

ER -

Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: A cross-sectional survey study

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