Increasing out-of-hospital regional surge capacity for H1N1 2009 influenza A through existing community pediatrician offices: a qualitative description of quality improvement strategies.
Abstract
OBJECTIVE
To describe initiatives undertaken by a network of community pediatricians to increase a city's surge capacity for patients
presenting with influenza-like illnesses during the 2009 H1N1 influenza A pandemic.
METHODS
This was a descriptive quality improvement project detailing the measures employed by a network of private practice community
pediatricians in Houston, Texas, caring for both insured and uninsured children.
RESULTS
Four categories of interventions were used: enhanced communication, increasing community pediatrician presence, vaccine distribution,
and targeted viral diagnosis and antiviral utilization. Promoting communication between clinicians, families, and an affiliated
local tertiary care children's hospital allowed for the efficient coordination of resources as well as a unified and consistent
message. Increasing access of families to their primary medical home by employing additional clinicians, extending office
hours, and locating additional space served to decrease the number of children with low-acuity illness seen in the local emergency
centers. Vaccine distribution was enhanced by effective communication between clinicians and families. Finally, targeted antiviral
testing and adherence to national recommendations on antiviral utilization enabled judicious utilization of a limited supply
of antiviral medications.
CONCLUSIONS
Effective communication and improved access to health care enabled children within the network with influenza-like illnesses
to continue to be cared for in their medical home. The measures used in response to novel influenza virus outbreaks can be
adapted for other situations requiring increased community surge capacity.
Links
Authors
Cruz AT, Tittle KO, Smith ER, Sirbaugh PE
Institution
Section of Emergency Medicine, Texas Children's Hospital, Houston, Texas, USA. acruz@bcm.edu
Source
Disaster medicine and public health preparedness 6:2 2012 Jun pg 113-6MeSH
Antiviral AgentsChild
Communication
Community Health Services
Health Services Accessibility
Humans
Influenza A Virus, H1N1 Subtype
Influenza Vaccines
Influenza, Human
Office Visits
Pandemics
Pediatrics
Quality Improvement
Surge Capacity
United States
Pub Type(s)
Journal ArticleResearch Support, Non-U.S. Gov't
Language
eng
PubMed ID
22700018
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