RT Journal Article
SR Electronic
T1 Learning lessons from the paediatric critical care response to the SARS-CoV-2 pandemic in England and Wales: a qualitative study
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP e1
OP e6
DO 10.1136/archdischild-2020-320662
VO 107
IS 3
A1 Roche, Emma
A1 Lim, Chun
A1 Sayma, Meelad
A1 Navaratnam, Annakan
A1 Davis, Peter J
A1 Ramnarayan, Padmanabhan
A1 Fraser, James
A1 Kenny, Simon
A1 
YR 2022
UL http://adc.bmj.com/content/107/3/e1.1.abstract
AB Objectives To explore the experiences of clinical leads in paediatric critical care units (PCCUs) in England and Wales during the reorganisation of services in the initial surge of the SARS-CoV-2 pandemic and to learn lessons for future surges and service planning.Methods A qualitative study design using semistructured interviews via virtual conferencing was conducted with consultant clinical leads and lead nurses covering 21 PCCUs. Interviews were conducted over a period of 2 weeks, 2 months after the initial SARS-CoV-2 surge. Interview notes underwent thematic analysis.Results Thematic analysis revealed six themes: leadership, management and planning; communication; workforce development and training; innovation; workforce experience; and infection prevention and control. Leadership was facilitated through clinician-led local autonomy for decision-making and services were better delivered when the workforce was empowered to be flexible in their response. Communication was preferred through collaborative management structures. Further lessons include recognising workforce competencies in surge preparations, the use of virtual technology in facilitating training and meetings, the importance of supporting the well-being of the workforce and the secondary consequences of personal protective equipment use.Conclusions During the 2020 SARS-CoV-2 pandemic, an agile response to a rapidly changing situation was enabled through effective clinical leadership and an adaptive workforce. Open systems of communication across senior clinical and management teams facilitated service planning. Support for all members of the workforce through implementation of appropriate and innovative education and well-being solutions was vital in sustaining resilience. This learning supports planning for future surge capacity across paediatric critical care locally and nationally.Data are available upon reasonable request, and where confidentiality to participants can be maintained. The datasets generated during the interviews are available, alongside the process of thematic analysis. However, interview data was collected confidentially and would need permission of the interviewee to disclose.