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急性和强化治疗环境中的危机准备:从新冠疫情一年中吸取的教训

Crisis Preparedness in Acute and Intensive Treatment Settings: Lessons Learned From a Year of COVID-19.

作者信息

Leffler Jarrod M, Esposito Cassandra L, Frazier Elisabeth A, Patriquin Michelle A, Reiman Meredith K, Thompson Alysha D, Waitz Carl

机构信息

Mayo Clinic, Rochester, Minnesota.

Cincinnati Children's Hospital Medical Center, Ohio.

出版信息

J Am Acad Child Adolesc Psychiatry. 2021 Oct;60(10):1171-1175. doi: 10.1016/j.jaac.2021.06.016. Epub 2021 Jul 2.

Abstract

The impact of COVID-19 changed the use and delivery of health care services, requiring an abrupt shift in treatment and staffing models . This is particularly salient in youth acute and intensive treatment services (AITS), including inpatient psychiatric hospitals (IPH), intensive outpatient programs (IOP), and partial hospitalization programs (PHP), because of challenging issues of maintaining high-quality care and a safe therapeutic milieu during increased demand for acute services, all while limiting transmission of COVID-19 on locked units, in close quarters, and for youths traveling back and forth to day-programs. Over the past year, AITS adapted and evolved without the ability to pause services and plan, increase staffing, or allocate additional resources. This article discusses themes of changes made based on more than 20 facilities across the United States through the American Psychological Association Child and Adolescent Psychology Division's Acute, Intensive, and Residential Service Special Interest Group. These facilities include psychiatric inpatient units and day-treatment programs. We discuss lessons learned from these changes, the need for evaluating these changes, and application of these lessons in future crises.

摘要

新冠疫情的影响改变了医疗服务的使用和提供方式,要求治疗和人员配置模式迅速转变。这在青少年急性和强化治疗服务(AITS)中尤为突出,包括住院精神病医院(IPH)、强化门诊项目(IOP)和部分住院项目(PHP),因为在急性服务需求增加期间,要维持高质量护理和安全的治疗环境存在诸多挑战,同时还要在封闭单元、近距离环境中以及青少年往返日间项目时限制新冠病毒的传播。在过去一年里,青少年急性和强化治疗服务在无法暂停服务、制定计划、增加人员配置或分配额外资源的情况下进行了调整和演变。本文通过美国心理协会儿童与青少年心理学分会的急性、强化和住院服务特别兴趣小组,探讨了美国20多家机构所做改变的主题。这些机构包括精神病住院单元和日间治疗项目。我们讨论了从这些改变中吸取的经验教训、评估这些改变的必要性,以及这些经验教训在未来危机中的应用。

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