Abstract
BackgroundThe COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system.MethodsFifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes.ResultsThe pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care.ConclusionsThe spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.
Highlights
The Emergency Department acts as a gateway to the health and social care system for many children, while providing critical care when other services are overburdened
The interruption to health and social care services is manifesting in myriad ways in the Emergency department (ED), such as a rise in psychosocial presentations
The “bread and butter” of paediatric presentations such as infectious diseases, viral illnesses and gastroenteritis cases notably decreased, while presentations relating to injuries and accidents, such as household injuries and accidental ingestions, decreased
Summary
A substantial reduction in paediatric emergency care utilization followed public health measures aimed at halting the spread of the virus, including school closures and restrictions on movement and social interactions This has raised concerns regarding potential delays in seeking healthcare [1, 2], and increased rates of morbidity and mortality due to delayed presentations have been reported [3,4,5]. Paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system
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