The rapid spread of COVID-19 put health care institutions around the country on high alert, with special emphasis placed on those Americans deemed to be most vulnerable or with pre-existing conditions. But what happens when your entire hospital is filled with patients who fit that criteria?
Such was the challenge faced at Totally Kids Rehabilitation Hospital, which for nearly 50 years has provided complex medical care and treatment to children, adolescents and young adults who are recovering from physical trauma or surgery, have suffered catastrophic illness, or who are dependent on technology.
“As soon as the coronavirus was barely a blip on anyone’s radar, it was apparent that given our patient population our challenges could be enormous,” said Racquel Arden, MA, RRT, HACP, CPHRM, vice president of regulatory compliance. “As a result, we immediately initiated daily incident command briefings with particular focus on exposure mitigation strategies (entry access, COVID-19 screening, visitation management); staffing, supplies, space (social distancing, isolation); and outreach to parents, referrers, volunteers and local agencies.”
Like all hospitals, Totally Kids rapidly implemented strict infection control policies with a focus on social distancing (including creating extra break room space), hand-washing (extra hand-hygiene stations and a portable hand-wash station outside of the hospital entrance) and proper use of personal protection equipment. This also included new internal controls regarding the cleaning and access to lab and radiology equipment as well as new safety precautions for employees in those departments. For all employees, Totally Kids provided education on how to minimize the virus’ spread and how to keep themselves and their families safe. In addition, the local public health task force provided on-site education and individual emotional support to relieve any fears.
Other actions the hospital took included establishing screening protocols in its reception area, permitting only a single-entry point into the facility and limiting visitations and movement on campus, including restricting access to medical students and non-essential consultants and vendors. And when worldwide shortages impacted access to supplies, Totally Kids called upon staff and local volunteers to make masks and reusable gowns.
Another very early step involved informing the parents of all patients on what the hospital was doing to protect the health of their child and to minimize the spread of COVID-19. “We called the families directly, sent letters, developed an FAQ document and set up a hotline for parents to call at any time with questions,” said Margarita Gil, MSN, RN, CRRN, vice president of patient care services.
“All family visits to Totally Kids’ subacute unit and Circlebrook Intermediate Care Facility were initially restricted completely and replaced by Skype and window visits as a way for families to keep in contact with their child,” Gil continued. “Recently, we implemented face-to-face visitation for parents in a controlled space without entering the hospital. Doing so is part of our commitment to find ways to bring children and their parents back together and to revive the touch and tenderness that makes families whole.”
The hospital also suspended operations of its KidShip program, a decision which Gil called a “painful but prudent action.” This unique preschool program brings medically fragile or developmentally delayed children together with kids without disabilities to play and learn in one supportive setting. Given that KidShip’s children include those with feeding tubes or catherization, those who are oxygen dependent, and those who require diabetic or ostomy care, Gil says that “suspending this program until further notice is, we believe, in the best interest of the health and safety of our students’ families and our team members.”
Today, Totally Kids’ leadership team continues to meet regularly to ensure that all of the precautions put in place are being practiced daily. The hospital also continues to test staff while remaining in close contact with local, state and federal authorities, including the county Department of Public Health, to stay abreast of current outbreak information and to follow the latest practices to limit the spread of COVID-19.
“Caring for children is a sacred bond—made even more so when these children are dependent on us for care during these most unusual times,” said Gil. “Children’s hospitals around the country are answering this call with unprecedented resiliency, and we are proud to be part of that fraternity.
Programs at Totally Kids Rehabilitation Hospital include pediatric acute rehabilitation, pediatric subacute and pediatric intermediate care. Find out more at TotallyKids.com, or follow us on Facebook at facebook.com/totallykidsrehab.
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