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Translating COVID-19 Pandemic Surge Theory to Practice in the Emergency Department: How to Expand Structure.

ABSTRACT: Multiple professional societies, nongovernment and government agencies have studied the science of sudden onset disaster mass casualty incidents to create and promote surge response guidelines. The COVID-19 pandemic has presented the health-care system with challenges that have limited science to guide the staff, stuff, and structure surge response.This study reviewed the available surge science literature specifically to guide an emergency department's surge structural response using a translational science approach to answer the question: How does the concept of sudden onset mass casualty incident surge capability apply to the process to expand COVID-19 pandemic surge structure response?The available surge structural science literature was reviewed to determine the application to a pandemic response. The on-line ahead of print and print COVID-19 scientific publications, as well as gray literature were studied to learn the best available COVID-19 surge structural response science. A checklist was created to guide the emergency department team's COVID-19 surge structural response.

SUBMITTER: Paganini M

PROVIDER: S-EPMC7156581 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Translating COVID-19 Pandemic Surge Theory to Practice in the Emergency Department: How to Expand Structure.

Paganini Matteo M Conti Andrea A Weinstein Eric E Della Corte Francesco F Ragazzoni Luca L

Disaster medicine and public health preparedness 20200327 4

Multiple professional societies, nongovernment and government agencies have studied the science of sudden onset disaster mass casualty incidents to create and promote surge response guidelines. The COVID-19 pandemic has presented the health-care system with challenges that have limited science to guide the staff, stuff, and structure surge response.This study reviewed the available surge science literature specifically to guide an emergency department's surge structural response using a translat ...[more]

PMID: 32216865

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Project description:PurposeThe coronavirus disease 2019 (COVID-19) pandemic is affecting all aspects of life and changing the practice of medicine. Multiple recommendations exist on how radiation oncology practices should deal with this crisis, but little information is available on what actually happens when the COVID-19 surge arrives. New York City experienced the first surge of COVID-19 in the United States and is now the epicenter of the global pandemic. This study reviews how COVID-19 has affected aspects of medicine, nursing, radiation therapy, and administration in a hospital system in New York.Methods and materialsA retrospective review was conducted of the department of radiation oncology in a single health system in New York from March 1, 2020, to April 1, 2020. Collaboration was obtained from physicians, nurses, radiation therapy staff, and administration to recall their policies and effect on specific duties. A timeline was reconstructed to chronicle significant events. Numbers were obtained for patients on treatment, treatment breaks, and COVID-19 infections among staff and patients.ResultsThe COVID-19 surge has had a tremendous effect on the health system, such as cessation of all of surgeries, including oncologic surgery, and transfer of all inpatient oncology services to makeshift outpatient facilities. Radiation oncology has made aggressive efforts to reduce the number of patients in treatment to protect patients and staff and to reallocate staff and space for more acute clinical needs. Patients on-beam were reduced by 27% from 172 to 125 by April 1. Almost all visits were changed to telemedicine within 2 weeks. Infection rates and quarantine were quite low among staff and patients. The majority of residents were deployed into COVID-19 clinical settings.ConclusionsAlthough we "planned for the worst," our health system was able to make necessary changes to still function at a reduced capacity. Our experience will give other departments a concrete experience to help them make their own policies and manage expectations.

Dataset Information

Translating COVID-19 Pandemic Surge Theory to Practice in the Emergency Department: How to Expand Structure.

Publications

Translating COVID-19 Pandemic Surge Theory to Practice in the Emergency Department: How to Expand Structure.

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