jaime blackwood

All this to say: given the costs to maintain these systems, we've always operated on the edge. This surge has demonstrated that the flexibility to quickly expand is not great, meaning cancelled surgeries, delayed transport from other hospitals, longer ER wait times, etc.

We care for children after surgery, children with mental health crises, children after trauma, children with severe infections, and so on. The case mix varies by season, by year, and by unit. Right now, it's almost all respiratory infections.

Provinces run their own system of care and transport, maintaining their own data and operational support. Benchmarking quality and tracking capacity across units in Canada is impossible, given our province-led systems. We have been pushing for this to change, but no luck so far.

To regionalize our care like this, we operate a large web of critical care transport systems to move children from smaller hospitals to one of our units. The lack of transport paramedics in Canada is a long-standing problem, and also not something easily scaled during surges.

To care for these children requires incredible expertise - nurses, respiratory therapists, pharmacists, doctors, physiotherapists, dieticians - all specifically trained to work with this specific community. It's not something that we can scale up quickly and maintain quality.

In Canada, we are a small field; just 17 hospitals care for every critically ill child in the country. There are less than 200 trained pediatric critical care physicians in the country.

Since pediatric critical care capacity is driving the news cycle right now, a thread on our field in Canada. /7