Academic Health Centers and Humanitarian Crises: One Health System's Response to Unaccompanied Children at the Border.

Child Humans COVID-19 Relief Work Pandemics One Health Disasters

Journal

Academic medicine : journal of the Association of American Medical Colleges
ISSN: 1938-808X
Titre abrégé: Acad Med
Pays: United States
ID NLM: 8904605

Informations de publication

Date de publication:
01 03 2023
Historique:
pubmed: 14 12 2022
medline: 25 2 2023
entrez: 13 12 2022
Statut: ppublish

Résumé

University of California Health (UCH) provided a system-wide, rapid response to the humanitarian crisis of unaccompanied children crossing the southern U.S. border in the midst of the COVID-19 pandemic in 2021. In collaboration with multiple federal, state, and local agencies, UCH mobilized a multidisciplinary team to deliver acute general and specialty pediatric care to unaccompanied children at 2 Californian emergency intake sites (EISs). The response, which did not disrupt normal UCH operations, mobilized the capacities of the system and resulted in a safe and developmentally appropriate environment that supported the physical and mental health of migrant children during this traumatic period. The capacities of UCH's 6 academic health centers ensured access to trauma-informed medical care and culturally sensitive psychological and social support. Child life professionals provided access to exercise, play, and entertainment. Overall, 260 physicians, 42 residents and fellows, 4 nurse practitioners participated as treating clinicians and were supported by hundreds of staff across the 2 EISs. Over 5 months and across both EISs, a total of 4,911 children aged 3 to 17 years were cared for. A total of 782 children had COVID-19, most infected before arrival. Most children (3,931) were reunified with family or sponsors. Continuity of care after reunification or placement in a long-term shelter was enhanced by use of an electronic health record. The effort provided an educational experience for residents and fellows with instruction in immigrant health and trauma-informed care. The effort benefitted from UCH's recent experience of providing a system-wide response to the COVID-19 pandemic. Lessons learned are reported to encourage the alignment and integration of academic health centers' capacities with federal, state, and local plans to better prepare for and respond to the accelerating need to care for those in the wake of disasters and humanitarian crises.

Identifiants

DOI: 10.1097/ACM.0000000000005097 PMID: 36512839 PMC: PMC9944367
pubmed: 36512839
doi: 10.1097/ACM.0000000000005097
pii: 00001888-202303000-00011
pmc: PMC9944367
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

322-328

Informations de copyright

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges.

Références

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Agency for Health Research and Quality. 2010 National Commission on Children and Disasters Report to the President and Congress. Rockville, MD: Agency for Health Research and Quality2010.
Disaster Preparedness Advisory Council. Committee on Pediatric Emergency Medicine. Ensuring the health of children in disasters. Pediatrics. 2015;136:e1407–e1417.
Schonfeld DJ, Demaria T; Disaster Preparedness Advisory Council and Committee on Psychosocial Aspects of Child and Family Health. Providing psychosocial support to children and families in the aftermath of disasters and crises. Pediatrics. 2015;136:e1120–e1130.
Adams E. Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense. Washington, DC: Justice Policy Institute2010.
Bath H. The three pillars of trauma informed care. Reclaiming Child Youth. 2008;17:17–21.
Ruzek J, Brymer M, Jacobs A, Layne C, Vernberg E, Watson P. Psychological first aid. J Mental Health Counsel. 2007;29:17–49.
Brymer M, Elmore Borbon D, Frymier S, et al. Psychological First Aid for Unaccompanied Children. Los Angeles, CA and Durham, NC: National Center for Child Traumatic Stress2021.
Babcock C, Theodosis C, Bills C, et al. The academic health center in complex humanitarian emergencies: Lessons learned from the 2010 Haiti earthquake. Acad Med. 2012;87:1609–1615.

Auteurs

Sherin U Devaskar (SU)

S.U. Devaskar is distinguished professor of pediatrics, David Geffen School of Medicine at UCLA, executive chair, Department of Pediatrics, UCLA, physician-in-chief, UCLA Mattel Children's Hospital, assistant vice chancellor of children's health, UCLA Health, and executive director, UCLA Children's Discovery and Innovation Institute, Los Angeles, California.

Coleen K Cunningham (CK)

C.K. Cunningham is pediatrician, UCI Health, Orange, chair, Department of Pediatrics, University of California, Irvine, School of Medicine, Irvine, and senior vice president and pediatrician-in-chief, Children's Hospital of Orange County, Orange, California.

Robin H Steinhorn (RH)

R.H. Steinhorn is professor and vice dean for children's clinical services, University of California San Diego, and president of children's specialists of San Diego and senior vice president, Rady Children's Specialists of San Diego, San Diego, California.

Cynthia Haq (C)

C. Haq is clinical professor and chair, Department of Family Medicine, UCI Medical Center, Orange, California.

Johnese Spisso (J)

J. Spisso is president, UCLA Health, chief executive officer, UCLA Hospital System, and associate vice chancellor, UCLA Health Sciences, Los Angeles, California.

William Dunne (W)

W. Dunne was administrative director of emergency preparedness, security, and safety services, UCLA Health, Los Angeles, California, at the time of writing. The author is currently director of emergency management, Penn State Health, Hershey, Pennsylvania.

Juan Raul Gutierrez (JR)

J.R. Gutierrez is associate clinical professor, Department of Pediatrics, UCSF School of Medicine, co-director of pediatrics, UCSF Health and Human Rights Initiative and the Center of Excellence for Immigrant Child Health and Wellbeing, San Francisco, California.

Coleen Kivlahan (C)

C. Kivlahan is medical director, UCSF Human Rights Clinic, UCSF Health and Human Rights Initiative, San Francisco, California.

Michelle Bholat (M)

M. Bholat is professor and executive vice-chair, Department of Family Medicine, David Geffen School of Medicine at UCLA, and executive director and co-founder, International Medical Graduate Program, UCLA Health, Los Angeles, California.

Suzanne Barakat (S)

S. Barakat is assistant professor, Family Community Medicine, and executive director, UCSF Health and Human Rights Initiative, San Francisco, California.

Mary Lou de Leon Siantz (ML)

M.L. de Leon Siantz is professor emeritus, Betty Irene Moore School of Nursing at UC Davis, and founding director, Center for the Advancement of Multicultural Perspectives on Science, Sacramento, California.

Stephanie Romero (S)

S. Romero is program manager, UCSF Health and Human Rights Initiative, San Francisco, California.

Chad T Lefteris (CT)

C.T. Lefteris is chief executive officer, UCI Health, Orange, California.

Samantha Gaffney (S)

S. Gaffney is manager in executive administration, UCLA Medical Center, Los Angeles, California.

Jaime Deville (J)

J. Deville is clinical professor of pediatrics, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, and UCLA Mattel Children's Hospitaldirector, Care-4-Families Clinic, UCLA Health, Los Angeles, California.

Carlos Lerner (C)

C. Lerner is professor of clinical pediatrics and chair in pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California.

Jasen Liu (J)

J. Liu is pediatrician, UCLA Health and UCLA Mattel Children's Hospital, Los Angeles, California.

Cynthia L Kuelbs (CL)

C.L. Kuelbs is clinical professor of pediatrics, UC San Diego School of Medicinechief medical information officer, Rady Children's Hospital, San Diego, California.

Sudeep Kukreja (S)

S. Kukreja is associate medical director and director of quality improvement, Neonatal Intensive Care Unit, Children's Hospital of Orange County, medical director, Newborn Hearing Screening Program, Children's Hospital of Orange County, and Mission Hospitalspecialist in neonatology, Children's Hospital of Orange County, Orange, California.

Charles Golden (C)

C. Golden is pediatrician and executive medical director, Primary Care Network, Children's Hospital of Orange County, Orange, California.

Zoanne Nelson (Z)

Z. Nelson is associate vice president, Finance and Administration, University of California Health, Oakland, California.

Kristie Elton (K)

K. Elton is systemwide program manager for environment, health, and safety, UC Office of the President, Oakland, California.

Carrie L Byington (CL)

C.L. Byington is professor of pediatrics and pediatric infectious diseases, UCSF School of Medicine, San Francisco, and executive vice president, University of California Health, Oakland, California.
ORCID: 0000-0002-7350-9495

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Academic Health Centers and Humanitarian...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Academic Health Centers and Humanitarian...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Academic Health Centers and Humanitarian...
questionsmedicales.fr › Environnement et santé publique › Environnement › Catastrophes › Coopération › Academic Health Centers and Humanitarian...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Épidémies de maladies › Épidémies › Pandémies › Academic Health Centers and Humanitarian...
questionsmedicales.fr › Caractéristiques de la population › Santé › Une seule santé › Academic Health Centers and Humanitarian...
questionsmedicales.fr › Environnement et santé publique › Environnement › Catastrophes › Academic Health Centers and Humanitarian...