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Respiratory ailments bring cyclical spikes to emergency departments (ED) but the 2022-2023 season had unique challenges, even compared to the unknowns of the COVID-19 pandemic when pediatric EDs were inundated with a surge of patients suffering from multiple respiratory ailments.
Life had returned to regular in-person activities for most Michigan children, including school, vacations, and community events by the fall 2022 months, but as winter approached and people began spending more time indoors, it came with a flu virus that hit earlier and more severely than usual. COVID-19 continued its years-long impact as a surge in Respiratory Syncytial Virus (RSV) added a third layer to an increasingly demanding season for pediatric emergency departments.
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Small, community hospitals to the largest health systems in the state were soon overwhelmed caring for children with multiple respiratory illnesses who needed increased levels of hands-on care, diagnostic measures including chest x-rays, as well as physical resources such as oxygen masks and hospital beds for lengthier hospital stays.
At the same time, health system administrators were managing staffing shortages, which were particularly harsh in nursing, and supply chain delays, while hospital employees and caregivers in all roles faced record levels of burnout after years of pandemic stress.
The Michigan Emergency Department Improvement Collaborative (MEDIC) quickly reprised its role as a convener of forums for the ED community to focus on emerging challenges and real-time solutions, while launching a new quality improvement campaign aimed at reducing costly tests that can cause a ripple effect of delayed care.
Town Halls Saving Lives
This season’s MEDIC pediatric respiratory surge town hall brought ED care providers and health system leaders together with a collegial understanding that each location would have its own set of barriers and opportunities. The focus was improving life-saving care for Michigan’s youngest and most vulnerable patients.
Providers and administrators shared real-time challenges and success stories for hands-on care, as well as managing staff, space, and supply shortages. The MEDIC town halls, toolkits, and other supporting resources are shared publicly for providers as a reference.
All in for Kids
Building on the town hall work from the fall, MEDIC launched its updated pay-for-performance and value-based reimbursement campaign for 2023 with goals to improve pediatric care in EDs. Utilizing online registry performance reports specific to their pediatric quality initiatives, MEDIC is assisting sites in identifying and addressing quality improvement opportunities in pediatric measures.
The new campaign, called “All in for Kids,” includes reducing unnecessary chest X-ray utilization, a key component of respiratory care. Utilizing MEDIC’s toolkits and resources, and despite the early surge of respiratory illnesses, member sites were able to reduce unnecessary chest X-rays in children, helping to lessen the strain on staff, resources, and equipment, while saving many children unnecessary testing and expediting their care.
The Value of MEDIC
As this respiratory season offered emergency departments unique challenges surrounding pediatric care, MEDIC took the opportunity to support member providers with comprehensive and up-to-date resources to facilitate better care for Michigan’s youngest patients while balancing efficiency. The ongoing “All in for Kids” campaign will continue to offer resources to providers to incentivize improving emergency care for pediatric patients, including platforms for engagement such as town halls and guest speakers on specialized topics, showcasing the unique way MEDIC is able to provide real solutions to crucial emergency care issues across Michigan.