An Education Intervention for Pediatricians During a Novel H1N1 Influenza Pandemic at a Children's Hospital

Background: In June 2009, the WHO declared novel H1N1 virus a worldwide pandemic. The novel H1N1 virus was of concern to pediatricians as it disproportionately affected children and young adults. At Baystate Medical Center, we saw 5 confirmed cases of novel H1N1 influenza, 119 presumed cases, and one death due to H1N1 influenza from April to August of 2009.

Objective: In addition to participating in a hospital wide response for preparedness, the pediatric infectious disease physicians designed an educational program for clinicians to increase knowledge, communication, and delivery of safe and efficient care to pediatric patients.  The final objectives were to assess participation, knowledge gained, and satisfaction with the educational intervention during a pandemic response.

Methods: The education program consisted of a Grand Rounds presentation, weekly updates at Pediatric Grand Rounds and implementation of a flu link on a hospital E-workplace website which provided updates as well as links to the CDC and the Massachusetts DPH websites. An electronic survey tool was designed to assess health care provider’s knowledge. It was distributed to hospital-based pediatricians and residents, local community pediatricians, family doctors, and nurse practitioners. The survey was distributed before and after the education intervention to assess knowledge retention and satisfaction with the program. Fisher’s exact test was performed on pre and post test knowledge responses.

Results: An email survey was sent to 225 pediatric care-providers. 128 of the pre-intervention surveys were returned yielding a response rate of 56%. 85 of the post-intervention surveys were returned, yielding a response rate of 38%. The percentage of correct responses to questions assessing provider knowledge of H1N1 influenza was compared pre-intervention and post-intervention. No statistically significant differences were found in the percentage of correct responses before and after the intervention. No significant changes were observed in individuals using e-workplace, the CDC website, or the MDPH website before and after the educational intervention. Pediatric residents were the only group to improve their scores (59.4% to 65.5%; p = 0.38).100% of those attending Grand Rounds found them to be informative or very informative. 35.4% of respondents did not attend. Of respondents attending either the flu updates or Grand Rounds, 93% stated they changed their practice based on information they gained from attending. 95% of those attending weekly flu updates had a positive response.

Conclusions: Providing information in several formats and utilizing electronic links and email may provide efficient means to contact local pediatric practitioners during an influenza pandemic. Knowledge retention may be poor after the initial waning of an outbreak in a regional setting. Satisfaction is highest with live presentations.