Pediatric Residency Program Response

The pediatric population seems to be less affected by severe disease caused by Coronavirus. There are additional factors contributing to the lower inpatient census as well as outpatient visit numbers including: 

  • Closure of schools / daycare which has slowed spread of flu, RSV, strep, and other common pediatric illnesses. 
  • Postponement of non-emergent procedures and admissions. 

With decreased patient volumes, we have restructured the CYAS resident schedule and clinical workflow to keep potential exposures to a minimum while continuing to support resident educations. Some measures include: 

  • Separation of ill and healthy patients and providers who see these patient cohorts
  • Postponement of non urgent appointments including well child visits which do not correlate with vaccination. 
  • More intensive phone and check-in screening / triaging
  • Institution of telemedicine visits by residents and attendings. 
  • Active monitoring of patient visit number and matching resident schedule to patient volume to minimize the number of providers in clinic at once. 

There have also been changes to the inpatient side including: 

  • Consolidation of pediatric units: C51 will house all admitted pediatric patients. The remaining units have been repurposed as adult units
  • Inpatient General Pediatrics  (Gray team) is temporarily closed. Patients needing admission will be transferred to other facilities. 
  • Restricting pediatric ICU admissions to non-covid or suspected covid patients. 
  • Restructuring resident coverage to eliminate redundancy and potential exposures: 
    • Day team now consists of: Gold team (2 residents), PICU (one resident), Blue team / inpatient flex (one intern).
    • Night Coverage will be provided by the PICU resident and a night time senior resident.
    • NICU coverage is unaffected.

There are concerns about these changes impacting clinical education. To mitigate the potential impact, residents are invited to rotate in subspecialty clinics which will continue to see patients on the telemedicine platform as well as select in-person visits. Relevant readings and online resources have been identified and distributed to our residents. 

As this is a very dynamic situation and may change.  If we enter a Pandemic response, our residents may be "redeployed." A number of residents have volunteered to be redeployed to adult services if needed, we will pull these residents preferentially before re-assigning others.  Regardless of where our residents may be working, they will continue to receive adequate supervision and PPE. Regardless of changes, all schedules will abide by ACGME duty hour restrictions. 

Pediatric Literature Reviews

Faculty members have been keeping current with research and publications regarding COVID-19. Roughly once per week, our providers compile relevant pediatric specific information for distribution to our department as well as other frontline providers.