Positive impacts of a dedicated General Paediatrics "home" ward in a tertiary paediatric Australian hospital.

Abstract

Whilst a centralised model of care intuitively makes sense and is advocated in other subspecialty areas of medicine, there is a paucity of supportive evidence for General Paediatrics. Following ward restructuring at our tertiary paediatric centre in preparation for the COVID-19 pandemic, a new dedicated General Paediatrics ward was established. We evaluated medical and nursing staff well-being, morale and perceived impacts on care after the ward's establishment. Experiences were sought from medical and nursing staff whom had worked across both previous wards caring for General Paediatrics patients, as well as the new dedicated General Paediatrics ward. Mandated responses used the format of much better, better, same, worse and much worse. A total of 73/82 (89%) medical and nursing staff completed the survey. A greater than 90% improved or neutral response was noted for 31/35 (89%) questions. About 80% of staff reported the new dedicated General Paediatrics ward provided a better or much better team-based approach, time efficient approach and overall model of care. A much better or better response was reported for communication between medical and nursing staff in 68%, team comradery in 69%, supportive/helpful nursing staff in 74%, job stress level in 66% and staff morale in 60% of respondents. Overwhelmingly positive responses from this study support a centralised or "home" ward model of care for General Paediatrics patients in a tertiary paediatric setting. Our findings may be relevant to General Paediatrics teams in other centres currently using multiple wards to manage their patients.