Physician-in-Chief's Message April 17, 2020

Dear Colleagues, Thank you for your continued hard work this week! Today, we are highlighting several unspoken heroes within our Children’s community! During my rounds this week, I continued to be so impressed with the incredible commitment to the families cared for at UNC Children’s.

UNC COVID Updates

Inpatient Care Changes to the Parent Visitation policy for inpatient pediatric patients are attached and can be found HERE These changes are effective immediately We appreciate everyone’s help in ensuring that we keep staff, providers, and families safe during these unprecedented times.

Ambulatory Care Thank you to everyone for transitioning to video visits! We realize these visits can be challenging and are not perfect (yet). Nursing staff is now doing triage for virtual patients ahead of the visit including med reconciliation, troubleshooting Mychart issues etc. So far the feedback on this assistance has been quite positive. Please remember the nurses/CMAs are not IT experts but will help as best they can to make the video visits work more smoothly. For video visits, there are virtual camera setups in Chapel Hill in the Pediatric Cardiology clinic (Ground floor Childrens) and at least 12 virtual setups in Raleigh. You may use your laptop or desktop computer if they have a camera.  We have heard lots of challenges with video visits and are working on those. We encourage everyone to obtain access to WebEx Teams. While it is not the preferred method for Video visits, it is an alternative if EPIC Videos are not working.  We would love to hear some stories of good things that have resulted from video visits like seeing environmental issues that might be exacerbating underlying health issues and being able to intervene or funny interactions that result from working with families in their "natural habitat."

Virtual Care Reminders to everyone now that virtual visits are being more widely used! Video visit billing should be done with all of the usual outpatient visit codes. Here's a 1-pager with virtual visit billing codes - You can print & carry it with you. Please try to use .pedvirtual as your dot phrase for your note. This imports typical note features but also has the system approved disclaimers and time documentation for phone OR video visits. If you would rather use your usual note template for video visits, you can use just the attestations from compliance and the system.

Emergency and Urgent Care Rapid COVID testing (45-60 minute turnaround time) now available for use in the ED for symptomatic admitted patients and for select symptomatic inpatients. See the Q&A below for more details!

The PED will now screen, evaluate and test (when appropriate) the parent/caregiver that presents with child in the ED. In brief, if the parent is non-toxic appearing, the PED provider will perform the MSE and the parent will be swabbed in peds.   If there is concern that the parent is sick, the pediatric ED attending will discuss with the team D attending to determine if the parent should be moved to team D for treatment or can be managed safely in place in the pediatric ED. The pathway is attached and can be found on Pediatrics COVID Resources.

Your COVID-19 Questions & Answers Response from Tom Belhorn Q: I heard we now have the new rapid test available at UNC. Will this change testing?   A: The rapid COVID test is now being used in the ED (as of late 4/16). Right now it is limited to tests for symptomatic patients being admitted, patients being admitted but unable to provide a history (e.g. severe trauma, psychotic, etc), and persons being admitted from a congregate setting experiencing a COVID outbreak.  The even better news is the general testing criteria are also being expanded. Two “new” criteria are loss of smell or taste (for any age patient) and children with nausea, vomiting, or diarrhea. The hope still is that we will soon have greater capabilities for testing and will further expand criteria. In house serology testing MAY be available as soon as the week of 4/27. We will keep you posted!

Connecting Coworkers to New Childcare Resources UNC Health and the UNC Task Force for Childcare for Healthcare Workers have partnered with the UNC Gillings School of Global Public Health to provide childcare resource information for all healthcare coworkers. See the available resources in English and Spanish . Visit the Well-Being Program page to access mental health/emotional support resources that meet your needs.

New Childcare Subsidy Programs Announced See the attached slides for more details. Program #1: Parent Financial Assistance for Emergency Childcare Funded through the North Carolina Department of Health and Human Services (NC DHHS) Applicable to any employee who has a household income below 300% of the federal poverty line Full funding available for childcare programs; rolling application time-frame Program #2: UNC Health’s Emergency Childcare Subsidy Program Established through private donations to the UNC Health Foundation through the COVID 19 Response Fund Applicable to all employees, including those who don’t wish to pursue NC DHHS funding Employees have five business days to apply; application approvals go out week of 4/27 Once approved, subsidy goes directly to employee via payroll for as long as there are donations to finance the program

Celebrating our Child Life Specialists We are lucky to have such dedicated professionals working with us throughout Children's. Below are just a few units and their Child Life Heroes!

Emergency While overall patient volume has been low, the Pediatric Emergency Department has seen a significant increase in traumatic injuries over the past several weeks. These visits are equally physically and mentally traumatic for children and their families. Luckily, we have two outstanding Child Life specialists who work full time in the Emergency Department who are dedicated to providing compassionate care to all patients and families who enter our space. While our nurses and physicians are receiving deserved attention from our community, we wanted to highlight Hanna Mixon and Kyra Koehler for displaying the same heroism every day in their work as gifted communicators, healers, and advocates. Raleigh Children's AnnaBella Cole and H eather Domenick are our Child Life specialists in Raleigh. They have been working through out the pandemic. They have been going the extra mile by helping with infusions, blood draws and with siblings that are worried about COVID. They are amazing!

Hematology/Oncology The three outpatient Child Life specialists in the HemOnc clinic are a special group. They are an important part of the part of the care of infants, children, youth, and families cope with the stress and uncertainty of illness and treatment. We are so glad Stacie Anderson, Henry Dearcia, and Meghan Fox are part of our team!

If you missed your chance to see Hamilton - At least you can check this out. The Zoom Where It Happens

These awkward video conference calls aren't exactly a new phenomenon but this video parody has never been more applicable!

I hope that each of you have some time to relax this weekend.  I am truly grateful for all that you do,

sddavis@med.unc.edu 919-417-3130 (cell)