Boston Children's Hospital, Department of Physical Therapy and Occupational Therapy Services, Boston, Massachusetts, USA.
Phys Ther. 2021 Sep 1;101(9). doi: 10.1093/ptj/pzab164.
The purpose of this case report is to describe the challenges that COVID-19 presented for therapists in a pediatric hospital and the response to these challenges.
The case report setting is a physical therapy and occupational therapy department (department) of an academic pediatric medical center that provides a range of health care services for children and youth. Challenges that COVID-19 presented to the department included (1) managing safety concerns for patients, their families, and staff; (2) continuing to provide high-quality therapy services within state-mandated restrictions; (3) triaging patients; and (4) keeping clinicians employed and working productively.
The department therapists responded to these challenges by (1) increasing communication huddles; (2) developing procedures for staffing and triaging of patients; (3) developing procedures for telehealth therapy services; and (4) designing a remote work program for all department employees. The number of patients and staff on site were reduced by initiating telehealth services, triaging patients, and developing a remote work plan. Communication huddles, department meetings, and supervision meetings were converted to virtual meetings. Staffing rates, patient-care productivity, and department project work were maintained.
In response to COVID-19, the department developed new protocols and provided information about the protocols, which might be helpful for other pediatric hospitals or outpatient settings when planning for future pandemics or other issues that challenge the ability to provide usual care. Increasing the frequency of verbal and written communication on operational topics is recommended. Primary sources of information from national organizations (eg, the American Physical Therapy Association and the American Occupational Therapy Association) can assist with determining the scope of practice and code of conduct during a pandemic.
COVID-19 posed challenges to operations and delivery of patient care. Although this case report is specific to COVID-19, principles applied and lessons learned from this experience can be applied to other emergency situations.
本病例报告旨在描述 COVID-19 给儿科医院治疗师带来的挑战以及对这些挑战的应对措施。
病例报告的背景是一家学术型儿科医疗中心的物理治疗和职业治疗部门（部门），为儿童和青少年提供一系列医疗保健服务。 COVID-19 给该部门带来的挑战包括：（1）管理患者、其家人和员工的安全问题；（2）在州规定的限制内继续提供高质量的治疗服务；（3）对患者进行分诊；（4）使临床医生保持就业和高效工作。
该部门治疗师通过以下方式应对这些挑战：（1）增加沟通碰头会；（2）制定人员配备和患者分诊程序；（3）制定远程医疗治疗服务程序；（4）为所有部门员工设计远程工作方案。通过启动远程医疗服务、对患者进行分诊以及制定远程工作计划，减少了现场的患者和员工人数。沟通碰头会、部门会议和监督会议改为虚拟会议。人员配备率、患者护理生产力和部门项目工作得以维持。
针对 COVID-19，该部门制定了新的协议并提供了有关协议的信息，这对于其他儿科医院或门诊环境在规划未来大流行或其他挑战提供常规护理能力的问题时可能会有所帮助。建议增加有关运营主题的口头和书面沟通频率。来自国家组织（例如，美国物理治疗协会和美国职业治疗协会）的主要信息来源可以帮助确定大流行期间的实践范围和行为准则。
COVID-19 对运营和患者护理的提供带来了挑战。尽管本病例报告专门针对 COVID-19，但从这次经历中应用的原则和吸取的教训可以应用于其他紧急情况。
