Sandra Fenwick, CEO of Boston Children's Hospital, has faced many difficulties throughout her career — the Boston marathon bombings, the H1N1 outbreak, hurricanes — but said the COVID-19 pandemic has been the most severe challenge to date.
In a Sept. 29 virtual event hosted by Boston-based Harvard T.H. Chan School of Public Health, Ms. Fenwick shared her experience leading a team of 20,000 people at Boston Children's, the No. 1 pediatric hospital in the nation, according to U.S. News & World Report. Boston Children's pandemic response has been similar to that of non-pediatric hospitals; they're prioritizing safety over everything else, according to Ms. Fenwick.
Below are six key takeaways:
1. Though children do have a lower recorded COVID-19 infection rate, this doesn't mean pediatric hospitals are less affected by the pandemic. Children typically have less severe symptoms than adults, and are less likely to be hospitalized, Ms. Fenwick said. However, when hospitalized, children end up in intensive care units about a third of the time, the same rate as adults requiring ICU care. Around 800 American kids have been affected by the serious inflammatory syndrome tied to COVID-19 as well.
2. Ms. Fenwick discussed issues unique to pediatric hospitals, such as the uncertainty around how COVID-19 affects children. Boston Children's became a pediatric coordinating center and developed an international collaboration effort regarding pediatric COVID-19 patients that includes the CDC and WHO. The hospital's community health office is also working with local health centers, agencies and schools across New England to reallocate resources to make sure families are receiving necessities amid the crisis.
3. A serious concern is that there has been a diminution of children's care, with drops in immunization rates and difficulties managing chronic conditions, according to Ms. Fenwick. Researchers at Boston Children's are analyzing factors that play a role in children falling ill with COVID-19 and why some are so severely affected by the disease.
4. Telehealth services currently account for about 50 percent of care at Boston Children's and are definitely here to stay, Ms. Fenwick said. Initially, the hospital's 9,000 employees moved to work remotely, and 85 percent of ambulatory work was done via telehealth at the height of the pandemic. In the beginning, the telehealth services were less satisfactory to both patients and clinicians, but people adapted quickly, soon hitting nines and 10s on a zero-to-10 satisfaction scale. Currently, the quality department is working to determine where telehealth has improved care and what areas should still be conducted in person, Ms. Fenwick explained.
5. Government leadership and policies need to invest in children, Ms. Fenwick said. Pediatric hospitals have unique revenue issues, including nearly 50 percent of U.S. children receiving Medicaid coverage. When funds are cut, these children are at risk.
6. Leaders should surround themselves with truly knowledgeable experts, Ms. Fenwick advised. Listen to others and build ideas off their knowledge.