How Can Pediatric Health Systems Flex to Accommodate a Surge of Hospitalized Adults?

A recent story in Modern Healthcare described how Children's Hospital Colorado is alerting community hospitals in its seven-state coverage area that it is accepting patients up to age 30 amid the outbreak. But how can pediatric health systems flex to accommodate a surge of hospitalized adults? Several pediatric providers are coming together to prepare for how to care for adult patients during the COVID-19 pandemic. Called Popcorn (Pediatric Overflow Planning Contingency Response Network), the group is a multi-institutional collaboration to help support the safe offloading of adult patients to pediatric facilities.

The Modern Healthcare story also noted that some children's hospitals are reluctant to take on adult patients and instead are urging hospitals to send children and adolescents to them to free up space. Yet some institutions seem interested in finding the best ways to utilize pediatricians. Popcorn’s mission is for pediatric providers and health systems to have access to tools and the community necessary to care for adult patients during the COVID-19 pandemic.

Co-founded by Leah Ratner, M.D., M.S., of Boston Children’s Hospital and Brigham and Women’s Hospital, and Ashley Jenkins, M.D., of Cincinnati Children’s Hospital and University of Cincinnati Medical Center, Popcorn has three working groups based on health system structure: community hospital, integrated/mixed hospital systems, and free-standing children’s hospitals. Other participants  are from organizations such as Children’s Hospital of Philadelphia, Baylor University and the University of Michigan.

Among its goals are to become an open access repository of information; synthesize information gathered and disseminate it frequently; work to establish “safe practices” regardless of care setting; and think critically about equity and health justice in the setting of COVID-19 response.

There are legal/business-related issues to work through, such as: Are there methods in place for billing and does the pediatric hospital have permission from the state to treat adults? What kind of credentialing do residents to work with adults?

Members are also trying to work through specific barriers that prevent smooth transitions of care to the adult population in pediatric hospitals. How should they handle patient flow — through the adult or pediatric emergency department and how can they streamline admission flow? (Currently most hospitals are funneling patients through adult ERs.)