Pediatrician Exposure to Neuromuscular Patients.

BACKGROUND: Primary care providers (PCPs) provide general care to patients, including those who are followed by specialists. In the field of rare diseases, there is growing research that the primary care needs of these patients are unique to their individual disease state. The purpose of this study is to determine the prevalence of patients with pediatric neuromuscular diseases among a subset of pediatric practices in Southeastern Wisconsin. METHODS: A retrospective review of all patients with neuromuscular diseases seen at Children's Hospital of Wisconsin (CW) was conducted from January 1, 2016 through September 30, 2018. All patients who were seen by Children's Medical Group (CMG) providers were included, with a division of patients by provider. RESULTS: Eight hundred eleven (811) unique pediatric neuromuscular patients were identified; 188 patients were included in the study cohort. The median number of patients per provider was 2.5, mean number of patients was 2.68, and mode number of patients was 1.74; 51% of pediatricians within CMG did not care for a pediatric neuromuscular patient. DISCUSSION: The prevalence of patients with neuromuscular diseases followed by an individual CMG provider is low, with over half of the CMG providers not caring for any patients with neuromuscular diseases. Given the specific primary care knowledge needed to care for these patients, this suggests the need for a novel method of help support these providers.

COVID-19 pre-procedural testing strategy and early outcomes at a large tertiary care children's hospital.

PURPOSE: With the emergence of the coronavirus disease-2019 (COVID-19) pandemic, institutions were tasked with developing individualized pre-procedural testing strategies that allowed for re-initiation of elective procedures within national and state guidelines. This report describes the experience of a single US children's hospital (Children's Wisconsin, CW) in developing a universal pre-procedural COVID-19 testing protocol and reports early outcomes. METHODS: The CW pre-procedural COVID-19 response began with the creation of a multi-disciplinary taskforce that sought to develop a strategy for universal pre-procedural COVID-19 testing which (1) maximized patient safety, (2) prevented in-hospital viral transmission, (3) conserved resources, and (4) allowed for resumption of procedural care within institutional capacity. RESULTS: Of 11,209 general anesthetics performed at CW from March 16, 2020 to October 31, 2020, 11,150 patients (99.5%) underwent pre-procedural COVID-19 testing. Overall, 1.4% of pre-procedural patients tested positive for COVID-19. By June 2020, CW was operating at near-normal procedural volume and there were no documented cases of in-hospital viral transmission. Only 0.5% of procedures were performed under augmented COVID-19 precautions (negative pressure environment and highest-level personal protective equipment). CONCLUSION: CW successfully developed a multi-disciplinary pre-procedural COVID-19 testing protocol that enabled resumption of near-normal procedural volume within three months while limiting in-hospital viral transmission and resource use.