242 - A Pediatric Residency' Program's Response to the "Tripledemic" Surge

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 242
Publication Number: 242.451

Jacob D. Rotter, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY, United States; Vassiliki Mirisis, Cohen Children's Medical Center, New Hyde Park, NY, United States; Alexandra Cummings, Cohen Children's Medical Center, Huntington Station, NY, United States; Stephen Barone, Cohen Children's Medical Center, New Hyde Park, NY, United States

Presenting Author(s)

JR

Jacob D. Rotter, MD (he/him/his)

Chief Resident
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Glen Oaks, New York, United States

Background: Pediatric departments were forced to implement many strategies in 2022 to manage a significantly increased volume of patients who suffered from respiratory viral illnesses. Pediatric residents were integral to most departments’ response to this surge. The Association of Pediatric Program Directors suggested a number of strategies, which could be used to mitigate negative effects of the surge.

Objective: To assess which mitigation strategies, as suggested by the APPD, were perceived to be most helpful to residents during the fall and winter surge in 2022.

Design/Methods: An anonymous survey was sent to 100 pediatric residents at a large children’s hospital to evaluate their perceived level of stress, workload, and which approaches have positively or negatively impacted their surge experience. 40 residents responded to the survey.

Results:
Based on a 5-point Likert scale, the residents' perceived stress increased prior to the surge from 3.4 to 4.1 during the surge (p < 0.001). Average perceived workload increased from 3.5 to 4.3 (p < 0.001). The most important sources of support identified included family (4.0) and their co-residents (3.9). Chief residents and program leadership were also identified as supportive (3.4).
The APPD has highlighted a number of strategies to help mitigate the burden of the surge, which aim to increase supply of available providers, increase efficiency of the system, and to decrease the demand on pediatric residents. Pediatric residents were asked to rate the effectiveness of these strategies on a 5-point Likert scale.
Residents perceived that the most effective strategies employed at our institution included moonlighting pay for additional shifts (4.4), increased food and snack availability (4.3), the creation of additional teams in high-volume or high-acuity areas (4.1), and enhanced communication in the form of more frequent town halls (4.0). Other effective strategies included utilization of ACPs (3.9), residents from other disciplines (family medicine and emergency medicine) (3.9), and fourth year medical students to help provide coverage (3.8).

Conclusion(s): The surge has had a self-evident negative impact on pediatric residents’ perceived well-being and workload. Residents felt largely supported by their family and peers, as well as by their chief residents and program leadership. The implemented action items as recommended by the APPD were deemed effective by the residents. Further studies are needed to evaluate novel strategies that reduce the burden on pediatric residents when pediatric hospital volumes increase either incrementally or during an unpredictable surge.