The Paediatric Palliative Care Unit has been transformed into Home Care Unit during the COVID-19 pandemic. Is this transformation for the foreseeable future?

Abstract

In the first wave of the coronavirus disease 2019 (COVID-19) pandemic, the declaration of the state of alert in Spain and the imposition of a lockdown on the population demanded the modification of multiple health care procedures and structures. In our hospital, we came to consider that home care, which was more developed at the time for adult patients,1,2 could be a useful alternative to face the challenges brought on by the lockdown. This article briefly describes the transformation of a paediatric palliative care unit (PPCU) into a paediatric home health care (PHHC) team and its operation from the start of the confinement (March 16) and May 24 (end of “phase 0” of the “reopening”). Our hospital has a catchment population of 261 632 inhabitants, 44 345 aged less than 18 years. An interdisciplinary PHHC team was formed, comprised of 2 paediatricians, 1 nurse and 1 clinical psychologist, through the transformation of the PPCU (which only had 1 paediatrician on staff). This team provided home-based care during diagnosis or follow-up to patients with acute or chronic disease (Table 1) referred from different paediatric speciality clinics (Table 2), in addition to continuing to provide the home-based care that the PPCU had been delivering before the pandemic and supporting other units, such as the human milk bank of Castilla y Leon. Our hospital already offered home-based and hospital-at-home care through the PPCU, but the adaptation to deliver care in other fields proved essential.