Background: The COVID-19 pandemic led to rapid changes in clinical service delivery across hospital systems nationally. Local realities and resources were key driving factors impacting workflow changes, including for pediatric consultation-liaison psychiatry service (PCLPS) providers. Objective: This study aims to describe the early changes implemented by 22 PCLPSs from the United States and Canada during the COVID-19 pandemic. Understanding similarities and differences in adaptations made to PCLPS care delivery can inform best practices and future models of care. Methods: A 20-point survey relating to PCLPS changes during the COVID-19 pandemic was sent to professional listservs. Baseline hospital demographics, hospital and PCLPS workflow changes, and PCLPS experience were collected from March 20 to April 28, 2020, and from August 18 to September 10, 2020. Qualitative data were collected from responding sites. An exploratory thematic analysis approach was used to analyze the qualitative data that were not dependent on predetermined coding themes. Descriptive statistics were calculated using Microsoft Excel. Results: Twenty-two academic hospitals in the United States and Canada responded to the survey, with an average of 303 beds/hospital. Most respondents (18/22) were children's hospitals. Despite differences in regional impact of COVID-19 and resource availability, there was significant overlap in respondent experiences. Restricted visitation to one caregiver, use of virtual rounding, ongoing trainee involvement, and an overall low number of COVID-positive pediatric patients were common. While there was variability in PCLPS care delivery occurring virtually versus in person, all respondents maintained some level of on-site presence. Technological limitations and pediatric provider preference led to increased on-site presence. Conclusions: To our knowledge, this is the first multicenter study exploring pandemic-related PCLPS changes in North America. Findings of this study demonstrate that PCLPSs rapidly adapted to COVID-19 realities. Common themes emerged that may serve as a model for future practice. However, important gaps in understanding their effectiveness and acceptability need to be addressed. This multisite survey highlights the importance of establishing consensus through national professional organizations to inform provider and hospital practices.
|Original language||English (US)|
|Journal||Journal of the Academy of Consultation-Liaison Psychiatry|
|Early online date||May 24 2021|
|State||E-pub ahead of print - May 24 2021|
Bibliographical noteFunding Information:
Funding: This research was supported in part by the Intramural Research Program of the NIMH (Annual Report Number ZIAMH002922).Finally, professional organizations such asAmerican Academy of Child and Adolescent Psychiatry and the Academy of Consultation-Liaison Psychiatry have played important roles in educating and supporting the PCLPS providers so far. This study highlights the need for future consensus guidelines being developed by these professional organizations to inform practice and ensure safety of everyone involved.
Funding: This research was supported in part by the Intramural Research Program of the NIMH (Annual Report Number ZIAMH002922 ).
© 2021 Academy of Consultation-Liaison Psychiatry
- consultation-liaison psychiatry
PubMed: MeSH publication types
- Journal Article