Pediatric capacity crisis: A framework and strategies to prepare for a pediatric surge

Diana M. Bongiorno*, Miranda Ravicz, Nicole L. Nadeau, Kenneth A. Michelson, Elizabeth R. Alpern, Sage R. Myers, Margaret E. Samuels-Kalow

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


A pediatric capacity crisis developed across the country in the Fall and Winter of 2022 due to a combination of factors, including a surge in respiratory viruses, staffing shortages, and historical closures of inpatient pediatric units. The COVID-19 pandemic and associated surge in critically ill adult patients demonstrated that health care systems and health care workers can quickly implement creative and collaborative system-wide solutions to deliver the best care possible during a capacity crisis. Similar solutions are needed to respond to future surges in pediatric volume and to maintain a high standard of care during such a surge. This paper aims to build upon insights from the COVID-19 and H1N1 pandemic responses and the 2022 pediatric capacity crisis. We provide specific recommendations addressing governmental/policy, hospital/health care system, and individual clinician strategies that can be implemented to manage future surges in pediatric patient volume.

Original languageEnglish (US)
Article numbere13093
JournalJACEP Open
Issue number1
StatePublished - Feb 2024


  • capacity crisis
  • health care systems
  • pediatrics
  • policy

ASJC Scopus subject areas

  • Emergency Medicine


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