P3A226: Pediatric Surge Playbook: Catastrophic Capable

Background: Given children are the most vulnerable segment of the population with unique physical and emotional needs, catastrophic disasters may overwhelm the pediatric healthcare system. Critical care bed needs, and resource demands may exceed capacity. Significant gaps exist in pediatric disaster preparedness and response which was evident during the RSV / Respiratory illness surge event. Hospitals nationally exceeded pediatric capability and capacity with limited critical care beds and trained professionals. Limited situation awareness, gaps in inter-hospital coordination, and critical care staffing contributed to expansion challenges and delayed patient transfer.

Project Description: This session proposes a Model Pediatric Surge PLAYBOOK guide to maximize and leverage surge operational capability during catastrophic events across coalitions, state, and regional borders. This unprecedented PLAYBOOK framework approach is designed to inform: “real time” situation awareness and patient movement decisions; surge expansion and decompression; and to support operational response including utilizing hospital Pediatric Emergency Care Coordinators (PECCs) and SMEs within state ICS organizations, Emergency Operation Centers (EOCs), Medical Operations Centers (MOCCs), coalitions, healthcare systems, and Hospital Incident Command Systems (HICS).

Discussion: This session demonstrates how multi-state HCC coalitions in California (CA) - Alameda and Orange County; Washington State (WA), and citywide in New York (NY) with collective Pediatric SMEs and coalitions have lifted jurisdiction's ability to support pediatric surge needs in the midst of the COVID & RSV / Respiratory Illness critical care surge. A compendium of insider experts including the California Hospital Association (CHA), ASPR Center of Excellence-Western Regional Alliance for Pediatric Emergency Management (WRAP-EM) & National Pediatric Disaster Coalition (NPDC) will share their experience with innovative operational Playbook solutions, evidence-based tools, strategic recommendations, and “best practice” resources for time-sensitive event needs.

Conclusion: The pediatric surge PLAYBOOK Concept of Operations components are highlighted to meet the challenge of disaster events which require multi-state and hospital coordination needs, situation awareness patient movement decisions, critical care expansion, contingency standards of care, access to SMEs for load leveling, resource matching and more. The proposed national pediatric surge future vision and advocacy action plan will be shared with the following objectives:

Facilitate understanding of proposed Model State & Multi-Jurisdiction Pediatric Surge PLAYBOOK (Guides / Tools) adapted for government ESF8 –EOCs, MOCCs, HCCs, and hospitals with evidence based essential elements, & “best practices”.

Provide access to pediatric SMEs & strategic options for “real time” catastrophic event situation awareness & response capabilities. Identify benefits of using Hospital Incident Command System (HICS) – Pediatric Technical Advisors, Pediatric Emergency Care Coordinators (PECCs), and response- based coalitions.

Identify how inclusive pediatric surge plans enabled optimal health system surge response in exercises & “real events” (including COVID-19 / RSV ) to address capability and capacity gaps. Provide multi-state coalition transformative pediatric surge approaches, recommendations, & solutions.