Paediatric “virtual wards” were reducing admissions well before the pandemic

Best’s article on using virtual wards to ease hospital pressures1 resonated with me because in paediatrics we have been doing this for over 25 years.2 Much of our paediatric practice could map nicely to adult care; the adage that children are little adults is untrue, but the reverse—adults being big children—holds some truth, medically speaking.The central tenet of ambulatory paediatrics, a concept described by Meates et al in 1997,3 is keeping children at home. In many situations, once children on the ward are getting better they can continue to improve at home. Sometimes their clinical condition allows them to be kept out of hospital altogether. A check-in phone call or community nurse visit can support the family.There is “no place like home.” Crucial to this are “ruby slippers” such as daily intravenous antibiotic regimens which enable ongoing treatment at home. High dose inhaled bronchodilator through spacers, as opposed to nebulisers,…
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