New study reports on secondary impacts of COVID-19 measures on hospital care for paediatric patients and families

Rapid and continuous changes in health care as a result of safety measures during the COVID-19 pandemic have greatly impacted the experience and delivery of care within hospitals. Researchers from The Hospital for Sick Children (SickKids) have reported insights indicating the consequences of these safety measures are likely much broader than anticipated. The paper was published January 12 in Hospital Pediatrics.

“Understanding the broader implications of hospital safety measures during the COVID-19 pandemic is necessary as we strive to deliver safe, high-quality and family-centered paediatric care over the coming months. Through this study, we were able to break down very complex and multi-faceted issues through real-life examples that highlighted the challenges we are seeing in health care,” says Dr. Jeremy Friedman, Associate Paediatrician-in-Chief at SickKids and senior author of the study.

COVID-19 safety measures resulted in adverse outcomes for paediatric patients and families

The research team surveyed frontline health-care providers, asking them to identify clinical cases that they perceived to have experienced suboptimal quality of care or health-related outcomes as a result of COVID-19-related closures. Key findings from more than 100 clinical cases submitted through the survey described multiple societal changes and transitions in health-care delivery that resulted in adverse health outcomes for paediatric patients.

Survey participants indicated that postponements in seeking medical attention – likely due to safety concerns – led to preventable intensive care admissions, as well as delayed diagnosis and treatment of life-threatening diseases. Visitor policy restrictions also resulted in family separation and disruption of support structures often at pivotal times during care, including disclosure of life-altering diagnoses. Other cases highlighted the challenges associated with virtual care and discharge planning for children with medical complexity due to limitations in home-care provider availability in the community.

Informing strategies to deliver optimal care during the pandemic

“The recognition of these unintended consequences is the first step in addressing and informing strategies to minimize harm for our patients and families. These findings provide important insights to paediatric hospitals as they continue to face challenges in providing the best possible care during the COVID-19 pandemic,” adds the study’s co-principal author, Dr. Catherine Diskin, Academic Paediatric Fellow, Complex Care at SickKids.

The researchers indicated that careful consideration within hospitals of the impact of each COVID-related policy change and enhanced communication with staff and the public, including the involvement of patient and family advisors, are essential to delivering optimal care to hospitalized children and their families during the remainder of the pandemic.

“Our study supports the importance of staying home and adhering to public health measures to reduce community transmission of COVID-19. By working together to flatten the curve, we can lessen the impacts on essential health care services for paediatric patients and their families,” emphasizes co-principal author Dr. Julia Orkin, Medical Officer, Integrated Community Partnerships at SickKids.

This research was funded by the Department of Paediatrics Creative Professional Activity Grant at SickKids and SickKids Foundation.